# PROVIDER CARE AT HOME LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Provider Care at Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538665211
- **Authorized official:** SHANE MILLER (ADMINISTRATOR/OWNER)
- **Authorized official phone:** (512) 793-9148

## Contact information

- **Practice address:** 900 NE LOOP 410 STE D427, SAN ANTONIO, TX 78209-1488
- **Practice address phone:** (210) 200-8718
- **Practice address fax:** (210) 200-8544
- **Mailing address:** 1714 FORTVIEW RD STE 106E, AUSTIN, TX 78704-7659
- **Mailing address phone:** (512) 212-1402

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251C00000X | Developmentally Disabled Services Day Training Agency | — | NULL | — |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 3747P1801X | Personal Care Attendant | — | NULL | — |
| 3747P1801X | Personal Care Attendant | — | — | — |

## Other

- **Enumeration date:** 04/02/2018
- **Last updated:** 07/17/2024