Healthcare Provider Details

I. General information

NPI: 1780095513
Provider Name (Legal Business Name): RUBLE ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 05/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2947 LANTANA RIDGE DR
AUSTIN TX
78732-2011
US

IV. Provider business mailing address

2900 N QUINLAN PARK RD SUITE B240-322
AUSTIN TX
78732-6083
US

V. Phone/Fax

Practice location:
  • Phone: 512-230-6610
  • Fax:
Mailing address:
  • Phone: 512-230-6610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SANDRA K RUBLE
Title or Position: DIRECTOR
Credential:
Phone: 512-230-6610