Kingdom Women LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10150H Issued in AZ

Legal business name

KINGDOM WOMEN LLC

Doing business as

Precious Jewels Home Care

Practice address

8311 W Forest Grove Ave
Tolleson, AZ 85353-3628

Phone

(816) 377-4224

Fax

(602) 687-9274

NPI assigned

Apr 12, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Myrrie Hayes

Title

Coowner

Phone

(816) 377-4224

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PRECIOUS JEWELS HOME CARE Doing business as

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491955200000",
    "number": "1902330392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4941 W DESERT LN",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853397365",
            "telephone_number": "816-377-4224",
            "fax_number": "602-687-9274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8311 W FOREST GROVE AVE",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853533628",
            "telephone_number": "816-377-4224",
            "fax_number": "602-687-9274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGDOM WOMEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-12",
        "last_updated": "2017-04-12",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "MYRRIE",
        "authorized_official_title_or_position": "COOWNER",
        "authorized_official_telephone_number": "816-377-4224",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL10150H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS MANAGE CARE NUMBER",
            "identifier": "225857",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRECIOUS JEWELS HOME CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Asiya Kenyatta
• Mehran Khanbabapour
• Neda Rezaei Khorrami
• Mamaleh Kiandoli
• Kassinda King Bayo
• Mandy Ba Kitamura, PHARMD
• Krown Wellnes by TK
• Jordan Laing, O.D.
• Nathaniel Lazan
• Thomas W Lear

• Assisted Living Facility in Tolleson, AZ
• Providers in Tolleson, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.