Provider Demographics
NPI:1174401970
Name:KINGDOM BUILDERS TRANSITIONAL HOUSING PROGRAM OF OHIO
Entity type:Organization
Organization Name:KINGDOM BUILDERS TRANSITIONAL HOUSING PROGRAM OF OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KERRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES-HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-805-6337
Mailing Address - Street 1:3659 GREEN RD STE 220
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5715
Mailing Address - Country:US
Mailing Address - Phone:330-805-6337
Mailing Address - Fax:
Practice Address - Street 1:3043 SUPERIOR AVE STE 202
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-4349
Practice Address - Country:US
Practice Address - Phone:330-805-6337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder