4 Corners Residential Care, Llc

NPI 1063657450 - Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities - 320600000X

NPI Details
NPI 1063657450
Enumeration Date 12/12/2008
Last Updated 12/12/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name RODERIC C RODERIC
Position PRESIDENT
Phone (313) 333-6947
Fax
Practice Location
408 W 17TH ST
STE 101
AUSTIN TX, 78701-1242, US
Phone (313) 333-6947
Fax
Business Location
408 W 17TH ST
STE 101
AUSTIN TX, 78701-1242, US
Phone (313) 333-6947
Fax
Toxanomy
Taxonomy Code 320600000X
License State
License Number
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According to our database, 4 Corners Residential Care, Llc NPI is 1063657450, taxonomy code is 320600000X 4 Corners Residential Care, Llc physically located at 408 W 17th St, Austin TX, 78701-1242. NPI Number 1033115704 has the healthcare provider type.

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1063657450 NPI number is provided on an as is basis without warranty of any kind. 1063657450 is maintained by the National Plan & Provider Enumeration System. The contents of 4 Corners Residential Care, Llc are for informational purposes only.