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Organization
WISTERIA HOME CARE LLC
Active
Organization
WISTERIA HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANA BENI (ADMINISTRATOR)
(512) 300-3085
Entity
Organization
Contact information
Practice address
209 12TH ST STE 211, PFLUGERVILLE, TX 78660-6208
(512) 300-3085
Mailing address
PO BOX 2424, PFLUGERVILLE, TX 78691-2424
(512) 300-3085
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
3747P1801X
Personal Care Attendant
—
NULL
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
12/17/2024
Last updated
08/18/2026
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