Basic Information
| Provider Information | |||||||||
| NPI: | 1164486718 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PRIME CARE SEVEN, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | BRIGHTON GARDENS OF AUSTIN | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7900 WESTPARK DR | ||||||||
| Address2: | ATTN: MEDICARE BILLING DEPT, M. GARCIA | ||||||||
| City: | MC LEAN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221024242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7038540823 | ||||||||
| FaxNumber: | 7038540164 | ||||||||
| Practice Location | |||||||||
| Address1: | 4401 SPICEWOOD SPRINGS RD | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787598682 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124188822 | ||||||||
| FaxNumber: | 5124188825 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2006 | ||||||||
| LastUpdateDate: | 06/18/2008 | ||||||||
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| AuthorizedOfficialLastName: | BURROWS | ||||||||
| AuthorizedOfficialFirstName: | DIAHN | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5124188822 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 115263 | TX | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.