Organization
CLARENCE & JEANNE KINSLEY, DBA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNE MARIE KINSLEY (OWNER/CHILDRENS RESPITE PROVIDER)
(928) 772-8070
Entity
Organization
Contact information
Practice address
17100 E. LIONS CROSSING RD, DEWEY, AZ 86327
(928) 772-8070
Mailing address
PO BOX 102, DEWEY, AZ 86327-0102
(928) 772-8070
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
BH4541
AZ
Other
Enumeration date
10/29/2015
Last updated
10/29/2015
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