Provider Demographics
NPI:1336772912
Name:KINTS LLC
Entity Type:Organization
Organization Name:KINTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TEIDE
Authorized Official - Middle Name:BRISIBE
Authorized Official - Last Name:EHIMARE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:573-639-0057
Mailing Address - Street 1:500 N MAIN ST STE 620
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201-4767
Mailing Address - Country:US
Mailing Address - Phone:808-909-2003
Mailing Address - Fax:808-909-2004
Practice Address - Street 1:100 CHESTERFIELD BUSINESS PKWY STE 200
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005-1271
Practice Address - Country:US
Practice Address - Phone:636-825-2200
Practice Address - Fax:636-825-2201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-21
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health