Provider Demographics
NPI:1366093130
Name:KOTOBI & ASSOCIATES, LLC
Entity type:Organization
Organization Name:KOTOBI & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTENA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOTOBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-946-1178
Mailing Address - Street 1:6101 W COURTYARD DRIVE
Mailing Address - Street 2:BLDG 1, SUITE 150
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730
Mailing Address - Country:US
Mailing Address - Phone:512-455-8888
Mailing Address - Fax:512-455-8888
Practice Address - Street 1:6101 W COURTYARD DRIVE
Practice Address - Street 2:BLDG 1, SUITE 150
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78730
Practice Address - Country:US
Practice Address - Phone:512-455-8888
Practice Address - Fax:512-455-8888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care