Provider Demographics
NPI:1417358813
Name:MY SAVIOR HOME HEALTHCARE, LLC
Entity Type:Organization
Organization Name:MY SAVIOR HOME HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:RISINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-356-9200
Mailing Address - Street 1:21818 HWY 71 W
Mailing Address - Street 2:STE 102
Mailing Address - City:SPICEWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78669-6815
Mailing Address - Country:US
Mailing Address - Phone:512-356-9200
Mailing Address - Fax:512-356-9223
Practice Address - Street 1:21818 HWY 71 W
Practice Address - Street 2:STE 102
Practice Address - City:SPICEWOOD
Practice Address - State:TX
Practice Address - Zip Code:78669-6815
Practice Address - Country:US
Practice Address - Phone:512-356-9200
Practice Address - Fax:512-356-9223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-04
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215611251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health