Provider Demographics
NPI:1639598527
Name:HOSPITALITY HOME HEALTHCARE AGENCY LLC
Entity Type:Organization
Organization Name:HOSPITALITY HOME HEALTHCARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OLATUNDE
Authorized Official - Middle Name:C
Authorized Official - Last Name:MUSTAPHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-803-6458
Mailing Address - Street 1:PO BOX 16374
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78761-6374
Mailing Address - Country:US
Mailing Address - Phone:512-803-6458
Mailing Address - Fax:
Practice Address - Street 1:1508 THIBODEAUX DR
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-7208
Practice Address - Country:US
Practice Address - Phone:512-803-6458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-08
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health