Provider Demographics
NPI:1841558640
Name:KING HEALTH SYSTEMS, INC
Entity Type:Organization
Organization Name:KING HEALTH SYSTEMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SULE
Authorized Official - Middle Name:I
Authorized Official - Last Name:SALAKO
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:410-578-4340
Mailing Address - Street 1:3502 W ROGERS AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-4749
Mailing Address - Country:US
Mailing Address - Phone:410-578-4340
Mailing Address - Fax:410-578-4342
Practice Address - Street 1:3502 W ROGERS AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-4749
Practice Address - Country:US
Practice Address - Phone:410-578-4340
Practice Address - Fax:410-578-4342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD404331600251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health