=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922957372
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KIND HORIZONS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2026
-----------------------------------------------------
Last Update Date | 01/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3927 W WILLOW HWY
-----------------------------------------------------
City | LANSING
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48917-2148
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 616-516-0095
-----------------------------------------------------
Fax | 616-516-0095
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3927 W WILLOW HWY
-----------------------------------------------------
City | LANSING
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48917-2148
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 616-516-0095
-----------------------------------------------------
Fax | 616-516-0095
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LICENSEE
-----------------------------------------------------
Name | INKOSINATI RASSEL KHAKA
-----------------------------------------------------
Credential | KHAKA
-----------------------------------------------------
Telephone | 616-516-0095
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 372600000X
-----------------------------------------------------
Taxonomy Name | Adult Companion
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------