Organization
CENIKOR FOUNDATION
Active
Parent organization
CENIKOR FOUNDATION
Other names
Joseph R Briscoe Treatment Center Detox
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENIKOR FOUNDATION
Authorized official
MATT KUHLMAN (CFO)
(713) 266-9944
Entity
Organization
Contact information
Practice address
4012 AVENUE H, LAKE CHARLES, LA 70615-5186
(337) 491-2355
(337) 491-2492
Mailing address
PO BOX 4785, MSC 675, HOUSTON, TX 77210
(713) 266-9944
(713) 574-2940
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
481
LA
Other
Enumeration date
08/25/2011
Last updated
11/10/2020
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