Organization
CENIKOR FOUNDATION
Active
Other names
Cenikor Fundation
Organization subpart
No
Provider details
NPI number
Authorized official
SPENCER DICKEY (MANAGER PAYER RELATIONS)
(806) 928-2447
Entity
Organization
Contact information
Practice address
1313 MISSION AVE NE, FARMINGTON, NM 87401
(505) 327-7218
Mailing address
PO BOX 4785 MCS# 675, HOUSTON, TX 77210
(713) 266-9944
(713) 574-2940
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
06/29/2021
Last updated
02/10/2025
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