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General NPI Number Information
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NPI Number | 1417358813
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Entity Type | Organization
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Legal Business Name | MY SAVIOR HOME HEALTHCARE, LLC
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Dates
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Enumeration Date | 09/04/2014
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Last Update Date | 09/08/2016
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Provider Practice Location Address
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Address Line | 21818 HWY 71 W STE 102
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City | SPICEWOOD
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State | TX
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Zip | 78669-6815
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Country | US
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Telephone | 512-356-9200
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Fax | 512-356-9223
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Provider Business Mailing Address
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Address Line | 21818 HWY 71 W STE 102
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City | SPICEWOOD
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State | TX
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Zip | 78669-6815
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Country | US
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Telephone | 512-356-9200
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Fax | 512-356-9223
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Authorized Official
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Title or Position | ADMINISTRATOR/CEO
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Name | MRS. LAUREN ASHLEY RISINGER
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Credential |
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Telephone | 512-356-9200
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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 | 215611
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License Number State | TX
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