Organization · NPI-2

Azaph Residential Home Care LLC

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities · Austin, TX

NPI number1841900198

StatusActive

Last updated in NPPESSep 13, 2023

Details

NPI: 1841900198
Entity type: Organization (NPI-2)
Legal business name: Azaph Residential Home Care LLC
Organization subpart: No
Enumeration date: Nov 28, 2022
Certification date: Sep 12, 2023
Last updated: Sep 13, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	–	–	Yes
171M00000X	Case Manager/Care Coordinator	–	–
364SL0600X	Clinical Nurse Specialist, Long-Term Care	–	–
385H00000X	Respite Care	–	–

Practice location

3516 Alpine Autumn Drive
Austin, TX 78744

Phone 325-668-9523

Mailing address

3516 Alpine Autumn Drive
Austin, TX 78744

Phone 325-668-9523

Authorized official

Olivier Gasore
Owner
3256689523

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