Healthcare Provider Details

I. General information

NPI: 1295350262
Provider Name (Legal Business Name): AGING IN YOUR OWN HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2020
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7768 YAUPON DR
AUSTIN TX
78759-6455
US

IV. Provider business mailing address

7768 YAUPON DR
AUSTIN TX
78759-6455
US

V. Phone/Fax

Practice location:
  • Phone: 512-221-2203
  • Fax: 512-229-9216
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: PRASAD PANWALKER
Title or Position: VICE PRESIDENT
Credential:
Phone: 512-294-3229