Provider Demographics
NPI:1245037852
Name:KINGDOM CARE LLC
Entity type:Organization
Organization Name:KINGDOM CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMUNITY HEALTH MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWNLEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-459-2829
Mailing Address - Street 1:13020 DURHAM DR
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-6913
Mailing Address - Country:US
Mailing Address - Phone:313-459-2829
Mailing Address - Fax:
Practice Address - Street 1:13020 DURHAM DR
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-6913
Practice Address - Country:US
Practice Address - Phone:313-459-2829
Practice Address - Fax:313-459-2829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-01
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management