Provider Demographics
NPI:1326559956
Name:TWENTY ONE RECOVERY AND CONSULT, INC.
Entity type:Organization
Organization Name:TWENTY ONE RECOVERY AND CONSULT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:R
Authorized Official - Last Name:SUEING
Authorized Official - Suffix:SR
Authorized Official - Credentials:OFFICER
Authorized Official - Phone:281-989-9419
Mailing Address - Street 1:2143 HAWTHORNE BROOK LN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-6080
Mailing Address - Country:US
Mailing Address - Phone:281-989-9419
Mailing Address - Fax:
Practice Address - Street 1:4301 VISTA RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-2117
Practice Address - Country:US
Practice Address - Phone:281-989-9419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111NR0400X
261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty