| NPI | 1235940321 |
|---|---|
| Doing Business As | KINGDOM KIDS IMPACT CHILD BEHAVIORAL SERVICES |
| Entity Type | Organization |
| Authorized Contact | TANISHA DACOSTA CEO 704-773-8115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Enumeration Date | 2025-01-16 |
| Last Update Date | 2025-01-29 |