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General NPI Number Information
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NPI Number | 1619235058
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Entity Type | Organization
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Legal Business Name | THE COTTAGES OF COUNTRY LANE LLC
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 04/23/2012
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Provider Practice Location Address
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Address Line | 470 BIG MEADOW RD
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City | AUSTIN
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State | TX
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Zip | 78737-4660
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Country | US
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Telephone | 512-383-5921
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Fax | 520-225-0194
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Provider Business Mailing Address
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Address Line | 470 BIG MEADOW RD
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City | AUSTIN
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State | TX
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Zip | 78737-4660
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Country | US
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Telephone | 512-383-5921
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Fax | 520-225-0194
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Authorized Official
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Title or Position | OWNER
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Name | RUBEN CONTRERAS
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Credential |
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Telephone | 512-383-5921
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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 |
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License Number State |
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