Clarence & Jeanne Kinsley, Dba

Primary specialty

Child Mental Illness Respite CareTaxonomy code 385HR2055X

License

BH4541 Issued in AZ

Legal business name

CLARENCE & JEANNE KINSLEY, DBA

Practice address

17100 E. Lions Crossing Rd
Dewey, AZ 86327

Phone

(928) 772-8070

NPI assigned

Oct 29, 2015

Last updated

Oct 29, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeanne Marie Kinsley

Title

Owner/Childrens Respite Provider

Phone

(928) 772-8070

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446076800000",
    "number": "1255703229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102",
            "city": "DEWEY",
            "state": "AZ",
            "postal_code": "863270102",
            "telephone_number": "928-772-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 E. LIONS CROSSING RD",
            "city": "DEWEY",
            "state": "AZ",
            "postal_code": "86327",
            "telephone_number": "928-772-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARENCE & JEANNE KINSLEY, DBA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-29",
        "last_updated": "2015-10-29",
        "status": "A",
        "authorized_official_last_name": "KINSLEY",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/CHILDRENS RESPITE PROVIDER",
        "authorized_official_telephone_number": "928-772-8070"
    },
    "taxonomies": [
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "AZ",
            "license": "BH4541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Child Mental Illness Respite Care in Dewey, AZ
• Providers in Dewey, AZ by specialty
• Child Mental Illness Respite Care in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.