Provider Demographics
NPI:1114248705
Name:SENIOR PREFERRED HOMECARE LLC
Entity Type:Organization
Organization Name:SENIOR PREFERRED HOMECARE LLC
Other - Org Name:FARMERS HOMECARE
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-284-7757
Mailing Address - Street 1:223 W ANDERSON LN STE A115
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-1212
Mailing Address - Country:US
Mailing Address - Phone:512-800-8911
Mailing Address - Fax:512-777-5044
Practice Address - Street 1:223 W ANDERSON LN STE A115
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-1212
Practice Address - Country:US
Practice Address - Phone:512-800-8911
Practice Address - Fax:512-777-5044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-17
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013558251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health