Provider Demographics
NPI:1164667218
Name:KOINONIA PARTNERS UNLIMITED, LLC
Entity Type:Organization
Organization Name:KOINONIA PARTNERS UNLIMITED, LLC
Other - Org Name:AKINS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEASTROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-588-8777
Mailing Address - Street 1:6161 OAK TREE BLVD
Mailing Address - Street 2:SUITE #400
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2516
Mailing Address - Country:US
Mailing Address - Phone:216-588-8777
Mailing Address - Fax:
Practice Address - Street 1:4740 AKINS RD
Practice Address - Street 2:
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-5373
Practice Address - Country:US
Practice Address - Phone:440-877-0636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KOINONIA PARTNERS UNLIMITED, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable