Provider Demographics
NPI:1942463278
Name:ASSURANCE CARE INC
Entity Type:Organization
Organization Name:ASSURANCE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:EWEKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-767-4128
Mailing Address - Street 1:12113 METRIC BLVD APT 1521
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-8631
Mailing Address - Country:US
Mailing Address - Phone:512-767-4128
Mailing Address - Fax:512-832-1354
Practice Address - Street 1:12113 METRIC BLVD APT 1521
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-8631
Practice Address - Country:US
Practice Address - Phone:512-767-4128
Practice Address - Fax:512-832-1354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities