Provider Demographics
NPI:1659840411
Name:KINGDOM PARTNERS CONNECTIONS LLC
Entity Type:Organization
Organization Name:KINGDOM PARTNERS CONNECTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-702-5611
Mailing Address - Street 1:PO BOX 138081
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34713-8081
Mailing Address - Country:US
Mailing Address - Phone:888-328-0004
Mailing Address - Fax:
Practice Address - Street 1:1920 VERANO DR STE 205
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-8585
Practice Address - Country:US
Practice Address - Phone:888-328-0004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-21
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities