Provider Demographics
NPI:1528579919
Name:AUSTIN ADULT HOMECARE
Entity Type:Organization
Organization Name:AUSTIN ADULT HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-975-5322
Mailing Address - Street 1:PO BOX 19601
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78760-9601
Mailing Address - Country:US
Mailing Address - Phone:210-975-5322
Mailing Address - Fax:
Practice Address - Street 1:5608 PALO BLANCO CT
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78744-3838
Practice Address - Country:US
Practice Address - Phone:210-975-5322
Practice Address - Fax:210-975-5322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities