Provider Demographics
NPI:1114361565
Name:RUTH'S KINGDOM, LLC
Entity Type:Organization
Organization Name:RUTH'S KINGDOM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:GATEWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:314-828-6273
Mailing Address - Street 1:3703 LAWLER DR APT H
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63121-3439
Mailing Address - Country:US
Mailing Address - Phone:314-828-6273
Mailing Address - Fax:314-828-6273
Practice Address - Street 1:3703 LAWLER DR APT H
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63121-3439
Practice Address - Country:US
Practice Address - Phone:314-828-6273
Practice Address - Fax:314-828-6273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-28
Last Update Date:2013-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care