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General NPI Number Information
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NPI Number | 1215356043
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Entity Type | Organization
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Legal Business Name | VIRTUE LLC
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 04/09/2014
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Provider Practice Location Address
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Address Line | 2423 S BELL BLVD STE B
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City | CEDAR PARK
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State | TX
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Zip | 78613-4754
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Country | US
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Telephone | 512-257-8888
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Fax | 512-257-8890
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Provider Business Mailing Address
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Address Line | 2423 S BELL BLVD STE B
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City | CEDAR PARK
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State | TX
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Zip | 78613-4754
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Country | US
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Telephone | 512-257-8888
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Fax | 512-257-8890
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Authorized Official
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Title or Position | OWNER
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Name | PAUL BRADLEY PARNHAM
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Credential |
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Telephone | 512-771-8241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 3-20438-7489-3
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License Number State | TX
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