Provider Demographics
NPI:1093096547
Name:KINGS CARE CENTERS LLC
Entity Type:Organization
Organization Name:KINGS CARE CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-391-6966
Mailing Address - Street 1:249 DESIGN PT
Mailing Address - Street 2:
Mailing Address - City:TOCCOA
Mailing Address - State:GA
Mailing Address - Zip Code:30577-7904
Mailing Address - Country:US
Mailing Address - Phone:706-391-6966
Mailing Address - Fax:706-391-6350
Practice Address - Street 1:249 DESIGN PT
Practice Address - Street 2:
Practice Address - City:TOCCOA
Practice Address - State:GA
Practice Address - Zip Code:30577-7904
Practice Address - Country:US
Practice Address - Phone:706-391-6966
Practice Address - Fax:706-391-6350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care