Healthcare Provider Details

I. General information

NPI: 1457582348
Provider Name (Legal Business Name): WESTLAKE CAREGIVERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2009
Last Update Date: 11/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 WESTLAKE DR # 202
WEST LAKE HILLS TX
78746-4511
US

IV. Provider business mailing address

1011 WESTLAKE DR # 202
WEST LAKE HILLS TX
78746-4511
US

V. Phone/Fax

Practice location:
  • Phone: 512-329-0001
  • Fax:
Mailing address:
  • Phone: 512-329-0001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateTX

VIII. Authorized Official

Name: MS. MARTHA BURGESS
Title or Position: ADMINISTRATOR
Credential:
Phone: 512-329-0001