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General NPI Number Information
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NPI Number | 1861635294
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Entity Type | Organization
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Legal Business Name | KINGDOM INVESTORS, LLC
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Dates
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Enumeration Date | 04/15/2009
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Last Update Date | 04/15/2009
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Provider Practice Location Address
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Address Line | 119 GREENSIDE AVE
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City | CANONSBURG
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State | PA
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Zip | 15317-1335
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Country | US
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Telephone | 724-746-3233
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Fax | 724-746-3233
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Provider Business Mailing Address
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Address Line | 119 GREENSIDE AVE
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City | CANONSBURG
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State | PA
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Zip | 15317-1335
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Country | US
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Telephone | 724-746-3233
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Fax | 724-746-3233
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Authorized Official
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Title or Position | OWNER
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Name | MR. GLENN BURNS
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Credential |
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Telephone | 724-746-3233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 402380
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License Number State | PA
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