Provider Demographics
NPI:1073974010
Name:KINSHIP RESIDENTIAL CARE, LLC
Entity Type:Organization
Organization Name:KINSHIP RESIDENTIAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:C
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-927-4916
Mailing Address - Street 1:PO BOX 300225
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77230-0225
Mailing Address - Country:US
Mailing Address - Phone:713-927-4916
Mailing Address - Fax:713-568-9446
Practice Address - Street 1:1119 THERESA ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77051
Practice Address - Country:US
Practice Address - Phone:713-927-4916
Practice Address - Fax:713-568-9446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-18
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility