Provider Demographics
NPI:1447658406
Name:KINSELLA CORPORATION
Entity type:Organization
Organization Name:KINSELLA CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KINSELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-703-1334
Mailing Address - Street 1:1405 SILVER LAKE RD NW
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-9301
Mailing Address - Country:US
Mailing Address - Phone:651-666-2095
Mailing Address - Fax:651-200-4175
Practice Address - Street 1:1405 SILVER LAKE RD NW
Practice Address - Street 2:SUITE 3
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-9301
Practice Address - Country:US
Practice Address - Phone:651-666-2095
Practice Address - Fax:651-200-4175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care