Individual
MR. JEFFREY RAYMOND KINNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
23 FIELDSTONE DRIVE, BANGOR, ME 04401
(207) 947-3176
(207) 945-9924
Mailing address
23 FIELDSTONE DRIVE, BANGOR, ME 04401
(207) 947-3176
(207) 945-9924
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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