Provider Demographics
NPI:1902604457
Name:NEW KINGDOM LIVING FOUNDATION CARE
Entity type:Organization
Organization Name:NEW KINGDOM LIVING FOUNDATION CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WARDLAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-443-6351
Mailing Address - Street 1:1800 POST OAK DR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-8515
Mailing Address - Country:US
Mailing Address - Phone:267-774-1625
Mailing Address - Fax:
Practice Address - Street 1:1800 POST OAK DR
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-8515
Practice Address - Country:US
Practice Address - Phone:267-774-1625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty