MEDICARE: ARDEN COURTS OF AUSTIN TX 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1487802351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARDEN COURTS OF AUSTIN TX LLC

Provider Business Mailing Address
First Line	:	333 N SUMMIT ST
Second Line	:	ATTN BARRY A LAZARUS
City	:	TOLEDO
State	:	OH
Zip	:	43604-1531
Country	:	US
Telephone Number	:	419-252-5541
Fax Number	:	419-254-5494

Provider Business Practice Location Address
First Line	:	11630 FOUR IRON DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-3100
Country	:	US
Telephone Number	:	512-918-2800
Fax Number	:	512-918-2862

Authorized Official
Title or Position	:	VICE PRESIDENT - REIMBURSEMENT
Name	:	MR. BARRY A LAZARUS
Credential	:
Telephone Number	:	419-252-5541

Provider Enumeration Date	:	09/04/2008
Last Update Date	:	09/04/2008

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