Provider Demographics
NPI:1528457801
Name:HIS GLOBAL KINGDOM INC
Entity type:Organization
Organization Name:HIS GLOBAL KINGDOM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHRSITIAN CLINICAL COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:MA CPC CCC
Authorized Official - Phone:601-336-9017
Mailing Address - Street 1:607 CORINNE ST
Mailing Address - Street 2:C3
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-3831
Mailing Address - Country:US
Mailing Address - Phone:601-336-9017
Mailing Address - Fax:601-336-9223
Practice Address - Street 1:607 CORINNE ST
Practice Address - Street 2:C3
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-3831
Practice Address - Country:US
Practice Address - Phone:601-336-9017
Practice Address - Fax:601-336-9223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-09
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6280347251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health