Healthcare Provider Details

I. General information

NPI: 1922920263
Provider Name (Legal Business Name): KINFOLK IA ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 12TH ST STE 1002
DES MOINES IA
50309-4246
US

IV. Provider business mailing address

204 12TH ST STE 1002
DES MOINES IA
50309-4246
US

V. Phone/Fax

Practice location:
  • Phone: 980-249-4010
  • Fax: 980-249-4011
Mailing address:
  • Phone: 980-249-4010
  • Fax: 980-249-4011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ZISHE RUBIN
Title or Position: CEO
Credential:
Phone: 917-246-8382