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General NPI Number Information
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NPI Number | 1326898974
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Entity Type | Organization
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Legal Business Name | AUSTINE LLC
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Dates
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Enumeration Date | 03/26/2024
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 4823 CAVE CREEK CT
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City | WALDORF
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State | MD
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Zip | 20602-3180
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Country | US
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Telephone | 443-926-9141
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Fax | 443-926-9263
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Provider Business Mailing Address
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Address Line | 4823 CAVE CREEK CT
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City | WALDORF
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State | MD
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Zip | 20602-3180
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Country | US
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Telephone | 443-926-9141
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Fax | 443-926-9263
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Authorized Official
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Title or Position | CEO
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Name | DORIS TERESA BRISCOE/NOLAN
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Credential | AGENT
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Telephone | 240-431-9358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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