Provider Demographics
NPI:1427588326
Name:ENTRUSTED PEDIATRIC HOME CARE L.L.C.
Entity type:Organization
Organization Name:ENTRUSTED PEDIATRIC HOME CARE L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:NORWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-532-4800
Mailing Address - Street 1:3921 STECK AVE STE A120
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8669
Mailing Address - Country:US
Mailing Address - Phone:512-532-4800
Mailing Address - Fax:512-735-2061
Practice Address - Street 1:3921 STECK AVE STE A120
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8669
Practice Address - Country:US
Practice Address - Phone:512-532-4800
Practice Address - Fax:512-635-2061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-14
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX376612301Medicaid
TX018275Medicaid