Provider Demographics
NPI:1821870692
Name:AUSTINS FAMILY CARE
Entity Type:Organization
Organization Name:AUSTINS FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DORA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BACA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-781-0341
Mailing Address - Street 1:7001 W 35TH AVE UNIT 277
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-7136
Mailing Address - Country:US
Mailing Address - Phone:786-781-0341
Mailing Address - Fax:
Practice Address - Street 1:7001 W 35TH AVE UNIT 277
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-7136
Practice Address - Country:US
Practice Address - Phone:786-781-0341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty