Provider Demographics
NPI:1780876714
Name:SERAH KINGS AGENCY
Entity type:Organization
Organization Name:SERAH KINGS AGENCY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SERAH
Authorized Official - Middle Name:NJERI
Authorized Official - Last Name:KINGORI
Authorized Official - Suffix:
Authorized Official - Credentials:VICE PRESIDENT
Authorized Official - Phone:978-453-0500
Mailing Address - Street 1:220 PAWTUCKET STREET SUITE 5
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854
Mailing Address - Country:US
Mailing Address - Phone:978-453-0500
Mailing Address - Fax:978-453-0599
Practice Address - Street 1:220 PAWTUCKET ST FL 5
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-6800
Practice Address - Country:US
Practice Address - Phone:978-453-0500
Practice Address - Fax:978-453-0599
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SERAH KINGS AGENCY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7353251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health