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KINGDOM HEALTHCARE SERVICES
NPI 1013667732
Clinic/Center - Developmental Disabilities in Homestead, FL

Active since March 25, 2022CLIA 10D2209566 · Waiver
1001 NE 15TH ST, HOMESTEAD, FL 33030(314) 620-6002 Get Directions Write a Review

NPPES record last updated: March 25, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kingdom Healthcare Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KINGDOM HEALTHCARE SERVICES (NPI 1013667732) is a healthcare organization registered as a developmental disabilities in Homestead, Florida and active in the NPI registry since March 2022. The organization holds a CLIA Waiver certificate valid through January 13, 2027 and lists Ketly Angoma, Owner, as its authorized official.

NPPES Registry Identity

NPI1013667732
Entity TypeOrganization
Primary Taxonomy261QD1600X
Legal Business NameKINGDOM HEALTHCARE SERVICES
Location Address1001 NE 15TH STHomestead, FL 33030-4956
Mailing Address1001 Ne 15th StHomestead, FL 33030-4956 · (314) 620-6002
Phone(314) 620-6002
Organization SubpartNo
Authorized OfficialKetly AngomaOwner · (314) 620-6002
Enumeration DateMarch 25, 2022
NPPES CertifiedMarch 25, 2022
✔ NPI 1013667732 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Developmental DisabilitiesAmbulatory Health Care Facilities
Taxonomy Code261QD1600X
Definition
An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
1001 NE 15TH ST, Homestead, FL 33030
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2209566

Kingdom Healthcare Services LLC · Homestead, FL
Active · expires Jan 13, 2027
CLIA Number10D2209566
Laboratory TypeSchool/Student Health Service
Certificate Effective DateJanuary 14, 2025
Certificate Expiration DateJanuary 13, 2027
Laboratory DirectorKetly Angoma
Laboratory Phone(314) 620-6002
Laboratory LocationKingdom Healthcare Services LLC100 NE 15th St, Ste 205, Homestead, FL 33030
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kingdom Healthcare Services's NPI number?

The NPI number for Kingdom Healthcare Services is 1013667732. It was assigned to this organization in the NPPES registry on March 25, 2022.

Where is Kingdom Healthcare Services located?

Kingdom Healthcare Services is located at 1001 NE 15th St, Homestead, FL 33030. The listed phone number is (314) 620-6002.

What is Kingdom Healthcare Services's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Developmental Disabilities, with taxonomy code 261QD1600X.

Does Kingdom Healthcare Services hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2209566) is associated with this NPI, valid through January 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kingdom Healthcare Services was last updated on March 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.