Provider Demographics
NPI:1578186615
Name:ATAND LLC
Entity Type:Organization
Organization Name:ATAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:RENAE
Authorized Official - Last Name:WOTIPKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-966-7402
Mailing Address - Street 1:1110 HERDER AVE
Mailing Address - Street 2:
Mailing Address - City:SCHULENBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78956-2214
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:610 LYONS AVE
Practice Address - Street 2:
Practice Address - City:SCHULENBURG
Practice Address - State:TX
Practice Address - Zip Code:78956-1522
Practice Address - Country:US
Practice Address - Phone:979-966-7402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-23
Last Update Date:2020-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty