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General NPI Number Information
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NPI Number | 1942463278
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Entity Type | Organization
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Legal Business Name | ASSURANCE CARE INC
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Dates
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Enumeration Date | 07/07/2008
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Last Update Date | 01/15/2009
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Provider Practice Location Address
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Address Line | 12113 METRIC BLVD APT 1521
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City | AUSTIN
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State | TX
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Zip | 78758-8631
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Country | US
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Telephone | 512-767-4128
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Fax | 512-832-1354
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Provider Business Mailing Address
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Address Line | 12113 METRIC BLVD APT 1521
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City | AUSTIN
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State | TX
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Zip | 78758-8631
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Country | US
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Telephone | 512-767-4128
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Fax | 512-832-1354
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MR. LARRY A EWEKA
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Credential |
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Telephone | 512-767-4128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State | TX
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