Provider Demographics
NPI:1316373780
Name:AT YOUR PLACE LLC
Entity Type:Organization
Organization Name:AT YOUR PLACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SANTOS
Authorized Official - Middle Name:GONZALEZ
Authorized Official - Last Name:CARRANZA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:254-315-7454
Mailing Address - Street 1:5517 STILLHOUSE HOLW
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76708-5697
Mailing Address - Country:US
Mailing Address - Phone:254-315-7454
Mailing Address - Fax:254-732-2731
Practice Address - Street 1:5517 STILLHOUSE HOLW
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-5697
Practice Address - Country:US
Practice Address - Phone:254-315-7454
Practice Address - Fax:254-732-2731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care