KEN ADOLPH WELLNESS LLC NPI 1396347514

NPI Information

NPI: 1396347514
Provider Name: KEN ADOLPH WELLNESS, LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
2911 MEDICAL ARTS ST STE 19A
AUSTIN, TX
ZIP 78705
Phone: (512) 686-5935
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KEN ADOLPH WELLNESS, LLC is a mental health (including community mental health center) clinic center in Austin, TX. KEN ADOLPH WELLNESS, LLC NPI is 1396347514. The provider is registered as an organization entity type.

The provider's business location address is:

2911 MEDICAL ARTS ST STE 19A
AUSTIN, TX
ZIP 78705-329
Phone: (512) 686-5935
Fax: (737) 242-9997

The provider's authorized official is Howard Kenneth Adolph .
The authorized official title is Founder/medical Director and has the following contact phone number (512) 750-1348.

The enumeration date for this NPI number is 11/12/2020 and was last updated on 11/12/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1215901368	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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