Provider Demographics
NPI:1093015679
Name:AW WE CARE COMMUNITY HOME CARE SERVICES
Entity Type:Organization
Organization Name:AW WE CARE COMMUNITY HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MYRA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LAVERGNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-346-1107
Mailing Address - Street 1:PO BOX 107
Mailing Address - Street 2:1383 FM 770 NORTH
Mailing Address - City:RAYWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77582-0107
Mailing Address - Country:US
Mailing Address - Phone:936-346-1107
Mailing Address - Fax:832-201-8768
Practice Address - Street 1:1383 FM 770 NORTH
Practice Address - Street 2:
Practice Address - City:RAYWOOD
Practice Address - State:TX
Practice Address - Zip Code:77582-0107
Practice Address - Country:US
Practice Address - Phone:936-346-1107
Practice Address - Fax:832-201-8768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health