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General NPI Number Information
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NPI Number | 1699217117
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Entity Type | Organization
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Legal Business Name | RIVERSIDE KEEPERS
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Dates
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Enumeration Date | 11/15/2016
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Last Update Date | 11/15/2016
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Provider Practice Location Address
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Address Line | 201 FM 3237 SUITE 124
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City | WIMBERLEY
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State | TX
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Zip | 78676-2117
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Country | US
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Telephone | 512-847-7080
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Fax |
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Provider Business Mailing Address
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Address Line | 201 FM 3237 SUITE 124
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City | WIMBERLEY
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State | TX
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Zip | 78676-2117
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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 | OWNER
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Name | ANN C GUILFORD
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Credential |
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Telephone | 512-847-7080
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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 | 7970
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License Number State | TX
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