Provider Demographics
NPI:1609483296
Name:CHINIQUE CARE LLC
Entity Type:Organization
Organization Name:CHINIQUE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TYRONE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-405-1202
Mailing Address - Street 1:13905 E 39TH ST S STE 105
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-3378
Mailing Address - Country:US
Mailing Address - Phone:816-405-1202
Mailing Address - Fax:816-256-4182
Practice Address - Street 1:13905 E 39TH ST S STE 105
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-3378
Practice Address - Country:US
Practice Address - Phone:816-405-1202
Practice Address - Fax:816-256-4182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-28
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services