| Kingdom Developmental Services | |
|
2109 Saint Andrew St Suite 12 Tarboro NC 27886-2149 | |
| (252) 641-6400 | |
| (252) 641-6431 |
| Full Name | Kingdom Developmental Services |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2109 Saint Andrew St, Tarboro, North Carolina |
| Authorized Official Name and Position | Vera Davis (PRESIDENT/CEO) |
| Authorized Official Contact | 2526416400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingdom Developmental Services 2109 Saint Andrew St Suite 12 Tarboro NC 27886-2149 Ph: (252) 641-6400 | Kingdom Developmental Services 2109 Saint Andrew St Suite 12 Tarboro NC 27886-2149 Ph: (252) 641-6400 |
| NPI Number | 1306154679 |
|---|---|
| Provider Enumeration Date | 09/20/2010 |
| Last Update Date | 09/20/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306154679 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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