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General NPI Number Information
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NPI Number | 1093015679
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Entity Type | Organization
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Legal Business Name | AW WE CARE COMMUNITY HOME CARE SERVICES
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Dates
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Enumeration Date | 10/28/2010
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Last Update Date | 10/28/2010
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Provider Practice Location Address
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Address Line | 1383 FM 770 NORTH
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City | RAYWOOD
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State | TX
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Zip | 77582-0107
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Country | US
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Telephone | 936-346-1107
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Fax | 832-201-8768
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Provider Business Mailing Address
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Address Line | PO BOX 107 1383 FM 770 NORTH
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City | RAYWOOD
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State | TX
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Zip | 77582-0107
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Country | US
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Telephone | 936-346-1107
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Fax | 832-201-8768
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MS. MYRA ANN LAVERGNE
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Credential |
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Telephone | 936-346-1107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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