Healthcare Provider Details

I. General information

NPI: 1619871910
Provider Name (Legal Business Name): KINDRED COMMUNITY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16513 GLIMMERING RD
MANOR TX
78653-5454
US

IV. Provider business mailing address

16513 GLIMMERING RD
MANOR TX
78653-5454
US

V. Phone/Fax

Practice location:
  • Phone: 512-964-6514
  • Fax:
Mailing address:
  • Phone: 512-964-6514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: SARA L WEBER
Title or Position: CEO
Credential: LPC-S
Phone: 512-964-6514