Living Kingdom Youth Development, Inc. | |
942 Wide Waters Pkwy Knightdale NC 27545-7322 | |
(919) 752-0800 | |
Not Available |
Full Name | Living Kingdom Youth Development, Inc. |
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Speciality | Behavior Analyst |
Location | 942 Wide Waters Pkwy, Knightdale, North Carolina |
Authorized Official Name and Position | Kimberly Fleetwood (OWNER) |
Authorized Official Contact | 9197520800 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Living Kingdom Youth Development, Inc. 942 Wide Waters Pkwy Knightdale NC 27545-7322 Ph: (919) 752-0800 | Living Kingdom Youth Development, Inc. 942 Wide Waters Pkwy Knightdale NC 27545-7322 Ph: (919) 752-0800 |
NPI Number | 1225354517 |
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Provider Enumeration Date | 04/13/2010 |
Last Update Date | 04/13/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225354517 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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