Provider Demographics
NPI:1780095513
Name:RUBLE ENTERPRISES, LLC
Entity type:Organization
Organization Name:RUBLE ENTERPRISES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:RUBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-230-6610
Mailing Address - Street 1:2900 N QUINLAN PARK RD
Mailing Address - Street 2:SUITE B240-322
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-6083
Mailing Address - Country:US
Mailing Address - Phone:512-230-6610
Mailing Address - Fax:
Practice Address - Street 1:2947 LANTANA RIDGE DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-2011
Practice Address - Country:US
Practice Address - Phone:512-230-6610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherEMPLOYER IDENTIFICATION NUMBER (EIN)