Provider Demographics
NPI:1083209571
Name:KING'S CIRCLE HOME HEALTH CARE
Entity Type:Organization
Organization Name:KING'S CIRCLE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-258-0956
Mailing Address - Street 1:27122 SPANISH WIND CT
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-6794
Mailing Address - Country:US
Mailing Address - Phone:713-258-0956
Mailing Address - Fax:
Practice Address - Street 1:27122 SPANISH WIND CT
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-6794
Practice Address - Country:US
Practice Address - Phone:713-258-0956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care