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General NPI Number Information
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NPI Number | 1265757520
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Entity Type | Organization
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Legal Business Name | SOULAGER, INC.
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Dates
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Enumeration Date | 03/30/2010
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Last Update Date | 03/30/2010
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Provider Practice Location Address
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Address Line | 121 RIVER BEND DR APT 1306
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City | GEORGETOWN
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State | TX
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Zip | 78628-3368
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Country | US
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Telephone | 512-331-4211
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Fax | 512-591-7202
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Provider Business Mailing Address
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Address Line | 121 RIVER BEND DR APT 1306
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City | GEORGETOWN
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State | TX
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Zip | 78628-3368
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Country | US
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Telephone | 512-331-4211
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Fax | 512-591-7202
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MS. DEBRA ANN WILLIAMS
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Credential |
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Telephone | 512-331-4211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 010589
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License Number State | TX
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