Provider Demographics
NPI:1194041418
Name:VEDOORN INC.
Entity Type:Organization
Organization Name:VEDOORN INC.
Other - Org Name:HILL COUNTRY CARE PROVIDERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VERDOORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-402-1119
Mailing Address - Street 1:2216 N RIVER HILLS RD APT B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78733-2146
Mailing Address - Country:US
Mailing Address - Phone:512-402-1119
Mailing Address - Fax:512-263-9104
Practice Address - Street 1:2216 N RIVER HILLS RD APT B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78733-2146
Practice Address - Country:US
Practice Address - Phone:512-402-1119
Practice Address - Fax:512-263-9104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-12
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009777251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health