Provider Demographics
NPI:1376227108
Name:KINERA LLC
Entity type:Organization
Organization Name:KINERA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIAWONA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:910-528-5799
Mailing Address - Street 1:701 GREEN VALLEY RD #100
Mailing Address - Street 2:STE 129
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408
Mailing Address - Country:US
Mailing Address - Phone:910-528-5799
Mailing Address - Fax:
Practice Address - Street 1:701 GREEN VALLEY RD #100
Practice Address - Street 2:STE 129
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408
Practice Address - Country:US
Practice Address - Phone:910-528-5799
Practice Address - Fax:336-332-2880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health