Healthcare Provider Details

I. General information

NPI: 1407573983
Provider Name (Legal Business Name): RESPITE HAUS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2022
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 NE INNER LOOP #14102
GEORGETOWN TX
78626
US

IV. Provider business mailing address

3001 NE INNER LOOP #14102
GEORGETOWN TX
78626
US

V. Phone/Fax

Practice location:
  • Phone: 956-313-9712
  • Fax:
Mailing address:
  • Phone: 956-313-9712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL

VIII. Authorized Official

Name: WENDY ADAMS
Title or Position: OWNER
Credential:
Phone: 956-313-9712