MEDICARE: VIRTUE LLC

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	251C00000X	Developmentally Disabled Services Day Training Agency	3-20438-7489-3	TX

General Provider Information

NPI Number	:	1215356043
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRTUE LLC

Provider Business Mailing Address
First Line	:	2423 S BELL BLVD STE B
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-4754
Country	:	US
Telephone Number	:	512-257-8888
Fax Number	:	512-257-8890

Provider Business Practice Location Address
First Line	:	2423 S BELL BLVD STE B
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-4754
Country	:	US
Telephone Number	:	512-257-8888
Fax Number	:	512-257-8890

Authorized Official
Title or Position	:	OWNER
Name	:	PAUL BRADLEY PARNHAM
Credential	:
Telephone Number	:	512-771-8241

Provider Enumeration Date	:	04/09/2014
Last Update Date	:	04/09/2014

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Directions to “VIRTUE LLC ” Practice Location

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