Individual
KENNETH ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
135 E MENEFEE ST, LUFKIN, TX 75901-4701
(936) 676-6433
Mailing address
135 E MENEFEE ST, LUFKIN, TX 75901-4701
(936) 676-6433
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
TX
253J00000X
Foster Care Agency
—
TX
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/05/2019
Last updated
08/05/2019
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