MEDICARE: KINSHIP PLACE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	311ZA0620X	Adult Care Home Facility
3	261QR0800X	Recovery Care Clinic/Center

General Provider Information

NPI Number	:	1750781217
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINSHIP PLACE

Provider Business Mailing Address
First Line	:	4436 ARBORWOOD TRL
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76123-2730
Country	:	US
Telephone Number	:	817-298-6533
Fax Number	:	817-297-1371

Provider Business Practice Location Address
First Line	:	4304 PECOS ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76119-5162
Country	:	US
Telephone Number	:	817-810-8193
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. KEARY ATKINSON
Credential	:	RN
Telephone Number	:	817-298-6533

Provider Enumeration Date	:	09/02/2014
Last Update Date	:	02/22/2024

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Directions to “KINSHIP PLACE ” Practice Location

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