Provider Demographics
NPI:1124101365
Name:ENMRSH, INC.
Entity type:Organization
Organization Name:ENMRSH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:DAMIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUFEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-762-3718
Mailing Address - Street 1:2700 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-1708
Mailing Address - Country:US
Mailing Address - Phone:575-762-3718
Mailing Address - Fax:575-763-4158
Practice Address - Street 1:2700 E 7TH ST
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-1708
Practice Address - Country:US
Practice Address - Phone:575-762-3718
Practice Address - Fax:575-763-4158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMD1808Medicaid
NME2543Medicaid