MEDICARE: CENTRE FOR NEURO SKILLS, INC.-TEXAS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM1300X	Multi-Specialty Clinic/Center
2	261QM2500X	Medical Specialty Clinic/Center
3	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1639216914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRE FOR NEURO SKILLS, INC.-TEXAS

Provider Business Mailing Address
First Line	:	5215 ASHE RD
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93313-2069
Country	:	US
Telephone Number	:	661-872-3408
Fax Number	:	661-872-5150

Provider Business Practice Location Address
First Line	:	1320 W. WALNUT HILL LANE
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75038-3007
Country	:	US
Telephone Number	:	972-580-8500
Fax Number	:	972-255-3162

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	CHARLES W SANDERS
Credential	:	CPA
Telephone Number	:	661-872-3408

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	08/02/2013

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