Provider Demographics
NPI:1114303658
Name:SOAL HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:SOAL HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SOFIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BASURTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-727-2385
Mailing Address - Street 1:1333 SHORE DISTRICT DR
Mailing Address - Street 2:1213
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-1300
Mailing Address - Country:US
Mailing Address - Phone:915-256-6666
Mailing Address - Fax:
Practice Address - Street 1:1333 SHORE DISTRICT DR
Practice Address - Street 2:1213
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741-1300
Practice Address - Country:US
Practice Address - Phone:915-256-6666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health