Provider Demographics
NPI:1023576964
Name:KINGDOM GIRLS
Entity Type:Organization
Organization Name:KINGDOM GIRLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DERRICKA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-577-8791
Mailing Address - Street 1:PO BOX 10102
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70181-0102
Mailing Address - Country:US
Mailing Address - Phone:504-577-8791
Mailing Address - Fax:
Practice Address - Street 1:1401 W ESPLANADE AVE
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-2845
Practice Address - Country:US
Practice Address - Phone:985-250-0385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable