Provider Demographics
NPI:1225175508
Name:CENTRE FOR NEURO SKILLS
Entity Type:Organization
Organization Name:CENTRE FOR NEURO SKILLS
Other - Org Name:CENTRE FOR NEURO SKILLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:W
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:661-872-3408
Mailing Address - Street 1:5215 ASHE RD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-2069
Mailing Address - Country:US
Mailing Address - Phone:661-872-3408
Mailing Address - Fax:661-872-5150
Practice Address - Street 1:5215 ASHE RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-2069
Practice Address - Country:US
Practice Address - Phone:661-872-3408
Practice Address - Fax:661-872-5150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM1300X, 261QM2500X, 261QR0400X
CA320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA157201395OtherDEPT OF HEALTH SERVICES
CA157201108OtherDEPT OF HEALTH SERVICES
CA12000203OtherDEPT OF HEALTH SERVICES