Provider Demographics
NPI:1225685241
Name:KINOB CARE LLC
Entity Type:Organization
Organization Name:KINOB CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LUCAS
Authorized Official - Middle Name:K
Authorized Official - Last Name:MUTURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-334-5668
Mailing Address - Street 1:PO BOX 27361
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-0139
Mailing Address - Country:US
Mailing Address - Phone:480-334-5668
Mailing Address - Fax:
Practice Address - Street 1:7249 E BLACK ROCK RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-6109
Practice Address - Country:US
Practice Address - Phone:480-334-5668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-23
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home