Provider Demographics
NPI:1770827008
Name:ALF SENIOR CARE 1 LLC
Entity type:Organization
Organization Name:ALF SENIOR CARE 1 LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:C
Authorized Official - Last Name:CARAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-413-3994
Mailing Address - Street 1:12400 W HIGHWAY 71
Mailing Address - Street 2:SUITE 350-391
Mailing Address - City:BEE CAVE
Mailing Address - State:TX
Mailing Address - Zip Code:78738-6517
Mailing Address - Country:US
Mailing Address - Phone:512-413-3994
Mailing Address - Fax:512-532-7515
Practice Address - Street 1:14109 FM 969
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78724-6368
Practice Address - Country:US
Practice Address - Phone:512-465-2190
Practice Address - Fax:512-465-2188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility