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General NPI Number Information
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NPI Number | 1700953916
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Entity Type | Organization
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Legal Business Name | KENMAR RESIDENTIAL SERVICES, INCORPORATED
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 3110 BUFFALO GAP RD
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City | ABILENE
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State | TX
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Zip | 79605-6810
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Country | US
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Telephone | 325-691-0810
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Fax | 325-691-1817
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Provider Business Mailing Address
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Address Line | 33 CYPRESS BLVD STE 100
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City | ROUND ROCK
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State | TX
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Zip | 78665-1006
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Country | US
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Telephone | 512-336-0800
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Fax | 512-336-0812
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Authorized Official
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Title or Position | EVP
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Name | AMANDA PEAKES-TAYLOR
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Credential |
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Telephone | 713-927-9920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 115078
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License Number State | TX
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