Healthcare Provider Details

I. General information

NPI: 1013418664
Provider Name (Legal Business Name): CLIN-COR CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2018
Last Update Date: 02/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HERITAGE CENTER CIR
ROUND ROCK TX
78664-4463
US

IV. Provider business mailing address

1000 HERITAGE CENTER CIR
ROUND ROCK TX
78664-4463
US

V. Phone/Fax

Practice location:
  • Phone: 210-870-7129
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateTX

VIII. Authorized Official

Name: NANCY MATALI
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 210-870-7129