Provider Demographics
NPI:1730808569
Name:PORCHIA RIDLEY & KINNEY FOUNDATION
Entity type:Organization
Organization Name:PORCHIA RIDLEY & KINNEY FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PORCHIA
Authorized Official - Prefix:
Authorized Official - First Name:LATONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:PORCHIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-338-3577
Mailing Address - Street 1:1235 W MARTIN LUTHER KING JR DR
Mailing Address - Street 2:
Mailing Address - City:SILSBEE
Mailing Address - State:TX
Mailing Address - Zip Code:77656-4537
Mailing Address - Country:US
Mailing Address - Phone:832-338-3577
Mailing Address - Fax:832-917-0075
Practice Address - Street 1:1235 W MARTIN LUTHER KING JR DR
Practice Address - Street 2:
Practice Address - City:SILSBEE
Practice Address - State:TX
Practice Address - Zip Code:77656-4537
Practice Address - Country:US
Practice Address - Phone:832-338-3577
Practice Address - Fax:832-917-0075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care