1295079721 NPI number — CARE WAY SENIOR LIVING, INC.

Table of content: (NPI 1295079721)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295079721 NPI number — CARE WAY SENIOR LIVING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARE WAY SENIOR LIVING, 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:
Provider Other Organization Name Type Code:
6
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:
1295079721
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/23/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11701 FM 2244
Provider Second Line Business Mailing Address:
STE. 221, RESACA PLAZA
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78738
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-761-3377
Provider Business Mailing Address Fax Number:
888-645-3641

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26409 HWY 71 E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HORSESHOE BAY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78657-6312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-596-1710
Provider Business Practice Location Address Fax Number:
830-596-1712
Provider Enumeration Date:
11/21/2012

Additional Information

Authorized Official

Authorized Official Last Name:
CARAWAY
Authorized Official First Name:
JASON
Authorized Official Middle Name:
CRAIG
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
512-761-3377

Provider Taxonomy Codes

  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 104874 . This is a "FACID" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com