MEDICARE: KINDVINE CARE AND SUPPORT SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1811873995
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINDVINE CARE AND SUPPORT SERVICES LLC

Provider Business Mailing Address
First Line	:	31 TEMPLE PL FL 1
Second Line	:
City	:	IRVINGTON
State	:	NJ
Zip	:	07111-2910
Country	:	US
Telephone Number	:	862-439-5607
Fax Number	:

Provider Business Practice Location Address
First Line	:	31 TEMPLE PL FL 1
Second Line	:
City	:	IRVINGTON
State	:	NJ
Zip	:	07111-2910
Country	:	US
Telephone Number	:	862-439-5607
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. IDOWU TITILAYO OLADEJI
Credential	:
Telephone Number	:	862-439-5607

Provider Enumeration Date	:	08/13/2025
Last Update Date	:	08/13/2025

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