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General NPI Number Information
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NPI Number | 1770827008
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Entity Type | Organization
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Legal Business Name | ALF SENIOR CARE 1 LLC
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Dates
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Enumeration Date | 11/27/2012
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Last Update Date | 11/27/2012
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Provider Practice Location Address
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Address Line | 14109 FM 969
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City | AUSTIN
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State | TX
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Zip | 78724-6368
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Country | US
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Telephone | 512-465-2190
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Fax | 512-465-2188
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Provider Business Mailing Address
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Address Line | 12400 W HIGHWAY 71 SUITE 350-391
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City | BEE CAVE
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State | TX
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Zip | 78738-6517
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Country | US
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Telephone | 512-413-3994
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Fax | 512-532-7515
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. JASON C CARAWAY
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Credential |
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Telephone | 512-413-3994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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