| Organization Name: | KINGSBROOK SENIOR CARE |
| NPI Number: | 1225338684 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TEMITAYO SODIMU (DIRECTOR) |
| Mailing Address: | 521 E Bolt St Fort Worth |
| State: | TX US |
| Postal Code: | 761106310 |
| Phone Number: | 8172025752 |
| Fax Number: | |
| NPI Enumeration Date: | 11/01/2010 |
| NPI Last Update Date: | 01/31/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |