Provider Demographics
NPI:1396007191
Name:KINDLE ROCK HEALTHCARE SERVICES INCORPORATED
Entity type:Organization
Organization Name:KINDLE ROCK HEALTHCARE SERVICES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MIMI
Authorized Official - Middle Name:MEMUNATU
Authorized Official - Last Name:CONNEH
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:281-733-8086
Mailing Address - Street 1:16918 IVER IRONWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2165
Mailing Address - Country:US
Mailing Address - Phone:281-892-1386
Mailing Address - Fax:281-892-1932
Practice Address - Street 1:16918 IVER IRONWOOD TRL
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-2165
Practice Address - Country:US
Practice Address - Phone:281-892-1386
Practice Address - Fax:281-892-1932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-08
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health