Organization
ICB ENTERPRISES CORPORATION
Active
Other names
Homewatch Caregivers of Southwest Austin
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAPHAEL HERNANDEZ (ADMINISTRATOR)
(512) 400-2333
Entity
Organization
Contact information
Practice address
11183 CIRCLE DR, SUITE C, AUSTIN, TX 78736
(512) 400-2333
(512) 400-2334
Mailing address
11183 CIRCLE C DR, SUITE C, AUSTIN, TX 78736
(512) 400-2333
(512) 400-2334
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
016857
TX
253Z00000X
In Home Supportive Care Agency
—
TX
253Z00000X
In Home Supportive Care Agency
—
—
3747P1801X
Personal Care Attendant
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3519480
—
TX
Enumeration date
03/02/2015
Last updated
02/19/2016
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