MEDICARE: ELIZABETH T EURESTI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1023341849
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELIZABETH T EURESTI

Provider Business Mailing Address
First Line	:	7402 ONION CROSSING DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78744-6526
Country	:	US
Telephone Number	:	512-698-1187
Fax Number	:

Provider Business Practice Location Address
First Line	:	7402 ONION CROSSING DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78744-6526
Country	:	US
Telephone Number	:	512-698-1187
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. ELIZABETH T EURESTI
Credential	:	CNA
Telephone Number	:	512-698-1187

Provider Enumeration Date	:	09/11/2009
Last Update Date	:	09/11/2009

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