King Certified Residential Facility

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

5324343 Issued in AL

Legal business name

KING CERTIFIED RESIDENTIAL FACILITY

Practice address

4008 Flatwoods Road
Northport, AL 35473-1101

Phone

(205) 792-7829

NPI assigned

Jul 22, 2008

Organization subpart

No

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

Authorized official

Name

Renee King Holley

Title

Family Provider

Phone

(205) 792-7829

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1497910244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4008 FLATWOODS RD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354731101",
            "telephone_number": "205-792-7829",
            "fax_number": "205-330-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4008 FLATWOODS ROAD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354731101",
            "telephone_number": "205-792-7829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING CERTIFIED RESIDENTIAL FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "HOLLEY",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "KING",
        "authorized_official_title_or_position": "FAMILY PROVIDER",
        "authorized_official_telephone_number": "205-792-7829"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "AL",
            "license": "5324343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott W Kemp, D.O.
• Scott Aaron Kennedy, DC
• Kelsey Grace Kent, LAT, ATC
• Gary Roderick Kilgo, MD
• Todd Kilpatrick
• Bryan R. King, MD, PHD
• Evan Brock Kirby
• Krista Klemm
• Emma Kathryn Knight, DDS
• Kenneth M Knight, DC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Northport, AL
• Providers in Northport, AL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.