Provider Demographics
NPI:1326546094
Name:CENIKOR FOUNDATION
Entity Type:Organization
Organization Name:CENIKOR FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:KUHLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-266-9944
Mailing Address - Street 1:PO BOX 4785
Mailing Address - Street 2:MSC 675
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2414 BUNKER HILL DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-3303
Practice Address - Country:US
Practice Address - Phone:888-236-4567
Practice Address - Fax:713-579-2940
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENIKOR FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-29
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty