Provider Demographics
NPI:1720214695
Name:ENTERHEALTH, LRC
Entity Type:Organization
Organization Name:ENTERHEALTH, LRC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIFFEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:800-388-4601
Mailing Address - Street 1:524 N LINCOLN PARK RD
Mailing Address - Street 2:
Mailing Address - City:VAN ALSTYNE
Mailing Address - State:TX
Mailing Address - Zip Code:75495-5012
Mailing Address - Country:US
Mailing Address - Phone:800-388-4601
Mailing Address - Fax:903-482-0910
Practice Address - Street 1:524 N LINCOLN PARK RD
Practice Address - Street 2:
Practice Address - City:VAN ALSTYNE
Practice Address - State:TX
Practice Address - Zip Code:75495-5012
Practice Address - Country:US
Practice Address - Phone:800-388-4601
Practice Address - Fax:903-482-0910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility