Provider Demographics
NPI:1366733180
Name:KENNENER AND JENKINS COMMUNITY SERVICES, INC.
Entity type:Organization
Organization Name:KENNENER AND JENKINS COMMUNITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EVERET
Authorized Official - Middle Name:E
Authorized Official - Last Name:KENNENER
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:979-297-7971
Mailing Address - Street 1:1909 WEST LOOP
Mailing Address - Street 2:
Mailing Address - City:EL CAMPO
Mailing Address - State:TX
Mailing Address - Zip Code:77437
Mailing Address - Country:US
Mailing Address - Phone:979-543-4186
Mailing Address - Fax:
Practice Address - Street 1:1909 WEST LOOP
Practice Address - Street 2:
Practice Address - City:EL CAMPO
Practice Address - State:TX
Practice Address - Zip Code:77437-8014
Practice Address - Country:US
Practice Address - Phone:979-543-4186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX125528320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX126366OtherDADS