# 4 CORNERS RESIDENTIAL CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063657450
- **Authorized official:** MR. RODERIC C HORTON (PRESIDENT)
- **Authorized official phone:** (313) 333-6947

## Contact information

- **Practice address:** 408 W 17TH ST, STE 101, AUSTIN, TX 78701-1242
- **Practice address phone:** (313) 333-6947
- **Mailing address:** 408 W 17TH ST, STE 101, AUSTIN, TX 78701-1242
- **Mailing address phone:** (313) 333-6947

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 12/12/2008
- **Last updated:** 12/12/2008