Provider Demographics
NPI:1275898934
Name:ELDER HOMECARE, INC.
Entity Type:Organization
Organization Name:ELDER HOMECARE, INC.
Other - Org Name:ELDER HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MIMI
Authorized Official - Middle Name:ANH-NGOC
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-826-2444
Mailing Address - Street 1:1512 W. HOWARD LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-7709
Mailing Address - Country:US
Mailing Address - Phone:512-826-2444
Mailing Address - Fax:512-275-6411
Practice Address - Street 1:1512 HOWARD LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-7709
Practice Address - Country:US
Practice Address - Phone:512-826-2444
Practice Address - Fax:512-275-6411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-09
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX014052251E00000X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No251E00000XAgenciesHome Health