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NPI Code Detail

MEDICARE: CENIKOR FOUNDATION

MEDICARE: CENIKOR FOUNDATION
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation Facility481LA
2261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number : 1447530134
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENIKOR FOUNDATION
Provider Business Mailing Address
First Line : PO BOX 4785
Second Line : MSC 675
City : HOUSTON
State : TX
Zip : 77210
Country : US
Telephone Number : 713-266-9944
Fax Number : 713-574-2940
Provider Business Practice Location Address
First Line : 4012 AVENUE H
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70615-5186
Country : US
Telephone Number : 337-491-2355
Fax Number : 337-491-2492
Authorized Official
Title or Position : CFO
Name : MATT KUHLMAN
Credential :
Telephone Number : 713-266-9944
Provider Enumeration Date : 08/25/2011
Last Update Date : 11/10/2020

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Directions to “CENIKOR FOUNDATION ” Practice Location

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