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General NPI Number Information
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NPI Number | 1568267698
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Entity Type | Organization
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Legal Business Name | CENIKOR FOUNDATION
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Dates
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Enumeration Date | 02/13/2025
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 814 CAMDEN ST
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City | SAN ANTONIO
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State | TX
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Zip | 78215-1445
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Country | US
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Telephone | 713-266-9944
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Fax | 713-574-2940
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Provider Business Mailing Address
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Address Line | PO BOX 392933
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City | PITTSBURGH
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State | PA
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Zip | 15251-9933
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Country | US
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Telephone | 806-928-2447
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Fax | 713-574-2940
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Authorized Official
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Title or Position | MANAGER OF PAYER RELATIONS
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Name | SPENCER DICKEY
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Credential |
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Telephone | 806-928-2447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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