| Kingdom Living Solutions | |
|
17325 Stricker Ave Eastpointe MI 48021-3103 | |
| (313) 806-3622 | |
| Not Available |
| Full Name | Kingdom Living Solutions |
|---|---|
| Speciality | Social Worker |
| Location | 17325 Stricker Ave, Eastpointe, Michigan |
| Authorized Official Name and Position | Denzel Raines (OWNER) |
| Authorized Official Contact | 3138063622 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingdom Living Solutions 17325 Stricker Ave Eastpointe MI 48021-3103 Ph: (313) 806-3622 | Kingdom Living Solutions 17325 Stricker Ave Eastpointe MI 48021-3103 Ph: (313) 806-3622 |
| NPI Number | 1457194128 |
|---|---|
| Provider Enumeration Date | 06/18/2024 |
| Last Update Date | 06/18/2024 |
| Certification Date | 06/18/2024 |
| Medicare PECOS PAC ID | 4385185388 |
|---|---|
| Medicare Enrollment ID | O20240918000460 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457194128 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Chlorine F Wimberly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598910986 PECOS PAC ID: 0840356465 Enrollment ID: I20090306000182 |
| Provider Name | Rita Turner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780152975 PECOS PAC ID: 2567716889 Enrollment ID: I20181126001357 |
| Provider Name | Emily Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730927476 PECOS PAC ID: 2062944259 Enrollment ID: I20241012000166 |
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