Organization
4 CORNERS RESIDENTIAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODERIC C HORTON (PRESIDENT)
(313) 333-6947
Entity
Organization
Contact information
Practice address
408 W 17TH ST, STE 101, AUSTIN, TX 78701-1242
(313) 333-6947
Mailing address
408 W 17TH ST, STE 101, AUSTIN, TX 78701-1242
(313) 333-6947
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/12/2008
Last updated
12/12/2008
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