Provider Demographics
NPI:1962662759
Name:GOD IS KING HOME HEALTH INC
Entity Type:Organization
Organization Name:GOD IS KING HOME HEALTH INC
Other - Org Name:VICTORIA HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:IFEYINWA
Authorized Official - Last Name:CHIBUEZE
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:915-587-5284
Mailing Address - Street 1:1005 DESIERTO SECO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1131
Mailing Address - Country:US
Mailing Address - Phone:915-587-5284
Mailing Address - Fax:
Practice Address - Street 1:1005 DESIERTO SECO DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1131
Practice Address - Country:US
Practice Address - Phone:915-587-5284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-15
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012557251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747427Medicare UPIN