Provider Demographics
NPI:1821079187
Name:KINSMAN ENTERPRISES, INC.
Entity Type:Organization
Organization Name:KINSMAN ENTERPRISES, INC.
Other - Org Name:ACCEL AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:C
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN
Authorized Official - Phone:214-327-1700
Mailing Address - Street 1:3218 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75705
Mailing Address - Country:US
Mailing Address - Phone:903-680-2220
Mailing Address - Fax:903-680-2221
Practice Address - Street 1:3218 N 4TH ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75705
Practice Address - Country:US
Practice Address - Phone:903-680-2220
Practice Address - Fax:903-680-2221
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KINSMAN ENTERPRISES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-11-12
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009608251E00000X
TX457834251E00000X
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45-7834Medicaid
TX178570101Medicaid
TX45-7834Medicaid