Provider Demographics
NPI:1346866456
Name:KINSEYS IV RESOURCES, LLC.
Entity Type:Organization
Organization Name:KINSEYS IV RESOURCES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:C
Authorized Official - Last Name:KINSEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:561-247-7920
Mailing Address - Street 1:300 10TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:LAKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33403-3167
Mailing Address - Country:US
Mailing Address - Phone:561-247-7920
Mailing Address - Fax:561-247-7929
Practice Address - Street 1:300 10TH ST STE 1
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-3167
Practice Address - Country:US
Practice Address - Phone:561-247-7920
Practice Address - Fax:561-247-7929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-24
Last Update Date:2020-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health