Provider Demographics
NPI:1447870753
Name:CLOVERLEAF SERVICES, INC
Entity type:Organization
Organization Name:CLOVERLEAF SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PARDEIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:512-461-1902
Mailing Address - Street 1:9501 ANCHUSA TRL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78736-2335
Mailing Address - Country:US
Mailing Address - Phone:512-461-1902
Mailing Address - Fax:
Practice Address - Street 1:9501 ANCHUSA TRL
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78736-2335
Practice Address - Country:US
Practice Address - Phone:512-461-1902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-16
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy