Provider Demographics
NPI:1730907890
Name:KING, SUSAN L (IJK CARE SERVICES)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:L
Last Name:KING
Suffix:
Gender:F
Credentials:IJK CARE SERVICES
Other - Prefix:MRS
Other - First Name:SUSAN
Other - Middle Name:L
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:IJK CARE SERVICES
Mailing Address - Street 1:94-1161 HEAHEA ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-4713
Mailing Address - Country:US
Mailing Address - Phone:808-729-8591
Mailing Address - Fax:
Practice Address - Street 1:94-1161 HEAHEA ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-4713
Practice Address - Country:US
Practice Address - Phone:808-729-8591
Practice Address - Fax:808-772-4757
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care