Organization
KID POTENTIAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDY FAULKNER (CHIEF FINANCIAL OFFICER)
(936) 539-4574
Entity
Organization
Contact information
Practice address
2912 W DAVIS ST, SUITE 140, CONROE, TX 77304-2041
(936) 539-4574
(936) 539-4585
Mailing address
PO BOX 2805, CONROE, TX 77305-2805
(936) 539-4574
(936) 539-4585
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
TX
Other
Enumeration date
01/04/2007
Last updated
08/22/2020
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