Provider Demographics
NPI:1093382962
Name:DEEMORGANS GROUP HOME
Entity Type:Organization
Organization Name:DEEMORGANS GROUP HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:737-600-5410
Mailing Address - Street 1:2207 WICKERSHAM LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-6075
Mailing Address - Country:US
Mailing Address - Phone:737-600-5410
Mailing Address - Fax:
Practice Address - Street 1:2207 WICKERSHAM LN APT 1310
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741-4752
Practice Address - Country:US
Practice Address - Phone:737-600-5410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health