Provider Demographics
NPI:1023553641
Name:KINGS BEHAVIORAL HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:KINGS BEHAVIORAL HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-594-2629
Mailing Address - Street 1:2158 CUMBERLAND PKWY SE
Mailing Address - Street 2:7202
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-4539
Mailing Address - Country:US
Mailing Address - Phone:919-594-2629
Mailing Address - Fax:
Practice Address - Street 1:2158 CUMBERLAND PKWY SE
Practice Address - Street 2:7202
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-4539
Practice Address - Country:US
Practice Address - Phone:919-594-2629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management