1538212949 NPI number — WILLIAMSON BURNET COUNTY OPPORTUNITES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538212949 NPI number — WILLIAMSON BURNET COUNTY OPPORTUNITES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAMSON BURNET COUNTY OPPORTUNITES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ROUND ROCK ADULT DAY HEALTH CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538212949
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 740
Provider Second Line Business Mailing Address:
604 HIGH TECH DRIVE (DO NOT MAIL TO STREET ADDRESS)
Provider Business Mailing Address City Name:
GEORGETOWN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78627-0740
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-763-1400
Provider Business Mailing Address Fax Number:
512-763-1400

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 S BROWN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROUND ROCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78664-5812
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-763-1400
Provider Business Practice Location Address Fax Number:
512-763-1400
Provider Enumeration Date:
01/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SHELL
Authorized Official First Name:
ANDREW
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
512-763-1400

Provider Taxonomy Codes

  • Taxonomy code: 261QA0600X , with the licence number:  00672 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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