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General NPI Number Information
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NPI Number | 1508312976
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Entity Type | Organization
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Legal Business Name | MANHAM ENTERPRISES LLC
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Dates
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Enumeration Date | 08/26/2016
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Last Update Date | 08/26/2016
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Provider Practice Location Address
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Address Line | 6500 RIVER PLACE BLVD BLDG 7 STE 250
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City | AUSTIN
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State | TX
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Zip | 78730-1119
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Country | US
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Telephone | 512-777-4092
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 COMFORT
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City | AUSTIN
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State | TX
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Zip | 78748-3070
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | STEVE WILLINGHAM
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Credential |
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Telephone | 512-777-4092
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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 | 016519
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License Number State | TX
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