Provider Demographics
NPI:1144769308
Name:KINESIS HOME CARE.LLC
Entity Type:Organization
Organization Name:KINESIS HOME CARE.LLC
Other - Org Name:CARDINAL REHAB SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JEZREEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-516-3466
Mailing Address - Street 1:3122 ARGENTO PL
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-4357
Mailing Address - Country:US
Mailing Address - Phone:844-892-5864
Mailing Address - Fax:512-215-4413
Practice Address - Street 1:3122 ARGENTO PL
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-4357
Practice Address - Country:US
Practice Address - Phone:844-892-5864
Practice Address - Fax:512-215-4413
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KINESIS HOME CARE.LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care