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General NPI Number Information
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NPI Number | 1558591917
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Entity Type | Organization
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Legal Business Name | SU VIDA HOME HEALTH, LLC
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Dates
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Enumeration Date | 07/20/2009
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Last Update Date | 09/04/2009
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Provider Practice Location Address
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Address Line | 7700 N. SH130 SVRD SB
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City | AUSTIN
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State | TX
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Zip | 78724-7200
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Country | US
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Telephone | 512-801-5403
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Fax | 512-276-1004
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Provider Business Mailing Address
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Address Line | 7700 N. SH130 SVRD SB
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City | AUSTIN
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State | TX
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Zip | 78724
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Country | US
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Telephone | 512-801-5403
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Fax | 512-276-1004
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANDREA OLIVAREZ
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Credential | RN
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Telephone | 512-801-5403
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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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