Provider Demographics
NPI:1043778632
Name:KINGTON KARE, INC.
Entity type:Organization
Organization Name:KINGTON KARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARVA
Authorized Official - Middle Name:
Authorized Official - Last Name:KINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-200-2916
Mailing Address - Street 1:4700 N HIATUS RD STE 253
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-7905
Mailing Address - Country:US
Mailing Address - Phone:754-900-4880
Mailing Address - Fax:754-600-3323
Practice Address - Street 1:4700 N HIATUS RD STE 253
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7905
Practice Address - Country:US
Practice Address - Phone:754-900-4880
Practice Address - Fax:754-600-3323
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KINGTON KARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299994631OtherAHCA