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General NPI Number Information
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NPI Number | 1841705118
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Entity Type | Organization
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Legal Business Name | KINGSLAND CARE SERVICES INCORPORATED
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Dates
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Enumeration Date | 12/08/2017
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 2301 RICE STREET SUITE 101
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City | ROSEVILLE
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State | MN
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Zip | 55113
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Country | US
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Telephone | 651-262-2540
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Fax | 651-493-8895
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Provider Business Mailing Address
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Address Line | 2301 RICE STREET SUITE 101
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City | ROSEVILLE
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State | MN
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Zip | 55113
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Country | US
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Telephone | 651-262-2540
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Fax | 651-493-8895
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICE
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Name | MR. ALBERT ABOUDEM ATEMKENG
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Credential | BSW, MSW, LGSW
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Telephone | 651-500-9053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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