Provider Demographics
NPI:1578277513
Name:SANDWYCH, INC.
Entity Type:Organization
Organization Name:SANDWYCH, INC.
Other - Org Name:SANDWYCH HEALTH AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-632-9391
Mailing Address - Street 1:919 CONGRESS AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-2114
Mailing Address - Country:US
Mailing Address - Phone:512-617-3200
Mailing Address - Fax:
Practice Address - Street 1:919 CONGRESS AVE STE 1400
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-2114
Practice Address - Country:US
Practice Address - Phone:512-617-3200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health