NPIMap

Organization Active NPI

Kenmar Residential Services, Incorporated

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Austin, TX
National Provider Identifier
1487721536
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
116079 Issued in TX
Legal business name
KENMAR RESIDENTIAL SERVICES, INCORPORATED
Practice address
12004 Cabana LN
Austin, TX 78727-5905
Phone
(512) 336-0800
Fax
(512) 336-0812
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amanda Peakes-Taylor
Title
Executive Vice President
Phone
(713) 927-9920

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 116079 TX Primary

Addresses

Primary practice location

12004 Cabana LN
Austin, TX 78727-5905

Mailing address

33 Cypress Blvd Ste 100
Round Rock, TX 78665-1006
Phone (512) 336-0800

Other identifiers 1

IdentifierTypeStateIssuer
45G351MedicaidTX

Other names 1

  • Kenmar Residential Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kenmar Residential Services13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764720000000",
    "number": "1487721536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 CYPRESS BLVD STE 100",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651006",
            "telephone_number": "512-336-0800",
            "fax_number": "512-336-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12004 CABANA LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787275905",
            "telephone_number": "512-336-0800",
            "fax_number": "512-336-0812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENMAR RESIDENTIAL SERVICES, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A",
        "authorized_official_last_name": "PEAKES-TAYLOR",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "713-927-9920"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "TX",
            "license": "116079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45G351",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kenmar Residential Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kenmar Residential Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.