Provider Demographics
NPI:1609092188
Name:ANCHOR CLANKER INC
Entity Type:Organization
Organization Name:ANCHOR CLANKER INC
Other - Org Name:KEYS TO RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:M
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, DCSW, SAP
Authorized Official - Phone:361-523-8241
Mailing Address - Street 1:PO BOX 1267
Mailing Address - Street 2:
Mailing Address - City:INGLESIDE
Mailing Address - State:TX
Mailing Address - Zip Code:78362-1267
Mailing Address - Country:US
Mailing Address - Phone:361-238-4083
Mailing Address - Fax:214-233-0329
Practice Address - Street 1:2051 W WHEELER AVE
Practice Address - Street 2:STE #5
Practice Address - City:ARANSAS PASS
Practice Address - State:TX
Practice Address - Zip Code:78336-4762
Practice Address - Country:US
Practice Address - Phone:361-523-8241
Practice Address - Fax:888-201-8760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
TXS095731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0002QAOtherBLUE CROSS BLUE SHIELD TX
TX=========OtherTRICARE
TX0002QAOtherBLUE CROSS BLUE SHIELD TX