Provider Demographics
NPI:1730884362
Name:KINLU LLC
Entity type:Organization
Organization Name:KINLU LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DENIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LUBINGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-640-1583
Mailing Address - Street 1:112 12TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-1826
Mailing Address - Country:US
Mailing Address - Phone:240-640-1583
Mailing Address - Fax:727-821-8510
Practice Address - Street 1:1810 S BELCHER RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-6602
Practice Address - Country:US
Practice Address - Phone:240-640-1583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility