Provider Demographics
NPI:1477710119
Name:THE KENSINGTON AGENCY INC
Entity Type:Organization
Organization Name:THE KENSINGTON AGENCY INC
Other - Org Name:ELITE CARE NURSES REGISTRY INC
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEAYDRE
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:PULLIAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-463-0473
Mailing Address - Street 1:8469 LA MESA BLVD
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-5335
Mailing Address - Country:US
Mailing Address - Phone:619-463-0473
Mailing Address - Fax:
Practice Address - Street 1:8469 LA MESA BLVD
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-5335
Practice Address - Country:US
Practice Address - Phone:619-463-0473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care