Provider Demographics
NPI:1033737465
Name:KINDRED CARE THERAPY
Entity Type:Organization
Organization Name:KINDRED CARE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-849-8619
Mailing Address - Street 1:3505 BECKFORD LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-2906
Mailing Address - Country:US
Mailing Address - Phone:910-849-8619
Mailing Address - Fax:
Practice Address - Street 1:213 DICK ST STE 200
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-5771
Practice Address - Country:US
Practice Address - Phone:910-849-8619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty