Provider Demographics
NPI:1063743417
Name:AEGIS SENIOR CARE GROUP, LLC
Entity type:Organization
Organization Name:AEGIS SENIOR CARE GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THERESA JASMIN
Authorized Official - Middle Name:ALANO
Authorized Official - Last Name:WILWAYCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-881-2781
Mailing Address - Street 1:120 ELDRIDGE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3185
Mailing Address - Country:US
Mailing Address - Phone:281-881-2781
Mailing Address - Fax:281-242-0892
Practice Address - Street 1:120 ELDRIDGE RD
Practice Address - Street 2:SUITE B
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3185
Practice Address - Country:US
Practice Address - Phone:281-881-2781
Practice Address - Fax:281-242-0892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-25
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care