Organization
AUSTIN GRACE HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SERGE MANZI (CHIEF EXECUTIVE OFFICER)
(512) 956-3938
Entity
Organization
Contact information
Practice address
12004 COPPERSTONE AVE, AUSTIN, TX 78748-4518
(512) 956-3938
Mailing address
12004 COPPERSTONE AVE, AUSTIN, TX 78748-4518
(512) 956-3938
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/10/2025
Last updated
04/10/2025
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