King and Lord Care 'KLC' LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

KING AND LORD CARE 'KLC' LLC

Practice address

501 Westbrook Street 209B
South Portland, ME 04106

Phone

(207) 321-1605

NPI assigned

Nov 4, 2022

Last updated

Nov 4, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Tresor Elijah Beya

Title

Chief Executive Officer Ceo

Phone

(207) 321-1605

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667520000000",
    "number": "1255048542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 WESTBROOK STREET 209B",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "04106",
            "telephone_number": "207-321-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 WESTBROOK STREET 209B",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "04106",
            "telephone_number": "207-321-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING AND LORD CARE 'KLC' LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A",
        "authorized_official_last_name": "BEYA",
        "authorized_official_first_name": "TRESOR",
        "authorized_official_middle_name": "ELIJAH",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER CEO",
        "authorized_official_telephone_number": "207-321-1605",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Soo Kim, MD
• Mijung Kim
• Sarah Richards Kim, M.D.
• Jackbarry Kimball
• Tyler Kimbar
• King Johnson Personal Care Services LLC (Personal Care)
• Caitlyn King-Khashroom
• Erin King, LCSW, APHSW-C
• Karyn Renee Aleta King, M.D.
• Samantha King, MA, LCMHC

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in South Portland, ME
• Providers in South Portland, ME by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.