MR. JEFFREY RAYMOND KINNEY (NPI# 1902933393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902933393 |
| Entity Type | Individual |
| Full Name | MR. JEFFREY RAYMOND KINNEY |
| Practice Address |
23 Fieldstone Drive Bangor ME 04401 |
| Practice Telephone | 2079473176 |
| Practice Fax Number | 2079459924 |
| Mailing Telephone | 2079473176 |
| Mailing Fax Number | 2079459924 |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205471299 | Jeffrey Kinney | Pharmacist | 1500 N Cedar Crest Blvd, Allentown, PA 18104-2357 | 2019-11-13 |
| Street Address |
23 FIELDSTONE DRIVE |
| City | BANGOR |
| State | ME |
| Zip Code | 04401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801923206 | Debra Raye Kinney | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 23 Fieldstone Drive, Bangor, ME 04401 | 2007-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245699461 | Creative Options, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1660 Ohio St, Bangor, ME 04401-2215 | 2016-02-16 |
| 1801923206 | Debra Raye Kinney | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 23 Fieldstone Drive, Bangor, ME 04401 | 2007-02-27 |
| 1447484027 | Darlene Marie Kenny | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 21 East St, Bangor, ME 04401-5802 | 2009-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033088 | Palms Residential Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1500 Forest Ave Apt 13d, Portland, ME 04103-1846 | 2020-11-06 |
| 1588264378 | Amahoro LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 59 Starboard Dr, Cape Elizabeth, ME 04107-9647 | 2020-10-29 |
| 1194340646 | Veritas Care of Maine Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 570 Brighton Ave Ste 2, Portland, ME 04102-2355 | 2020-06-10 |
| 1497387708 | Paradise Residential Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6 Stephanie Dr, Gorham, ME 04038-1394 | 2020-02-05 |
| 1679104673 | Dynamic Alternative Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 171 Brook St, Sanford, ME 04073-2505 | 2020-01-29 |
| 1811528920 | Alternative Residential Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 14 Joes Rd, Windham, ME 04062-4515 | 2020-01-28 |
| 1790321578 | Supportive Partnerships | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1 Fellows St, Portland, ME 04103-2414 | 2019-11-26 |
| 1437792199 | Atlantic Community Support LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 75 Bishop St Ste 13, Portland, ME 04103-2614 | 2019-10-24 |
| 1396390811 | Golden Group Home Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 40 Bernard Rd, Portland, ME 04103-3611 | 2019-08-02 |
| 1588217897 | Blue Star Homecare LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 23 Myrtle St Apt 102, Biddeford, ME 04005-3578 | 2019-07-17 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MR. JEFFREY RAYMOND KINNEY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.