Provider Demographics
NPI:1992363857
Name:KARA CLINELLC
Entity Type:Organization
Organization Name:KARA CLINELLC
Other - Org Name:RAINBOW STEPS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-514-7040
Mailing Address - Street 1:3337 PECAN ESTATES LN
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:MS
Mailing Address - Zip Code:38632-7361
Mailing Address - Country:US
Mailing Address - Phone:870-514-7040
Mailing Address - Fax:
Practice Address - Street 1:7075 GOLDEN OAKS LOOP W STE 2
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-9011
Practice Address - Country:US
Practice Address - Phone:870-514-7040
Practice Address - Fax:662-655-1331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty