Provider Demographics
NPI:1255198685
Name:THE KINEO CENTER LLC
Entity type:Organization
Organization Name:THE KINEO CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SKEENS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:602-388-3838
Mailing Address - Street 1:5228 N 15TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-3002
Mailing Address - Country:US
Mailing Address - Phone:602-388-3838
Mailing Address - Fax:
Practice Address - Street 1:5320 N 16TH ST STE 110
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-3241
Practice Address - Country:US
Practice Address - Phone:602-388-3838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty