Provider Demographics
NPI:1013023852
Name:COMMUNITY HOME CARE, INC.
Entity Type:Organization
Organization Name:COMMUNITY HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:956-725-3888
Mailing Address - Street 1:109 LAKE GENEVA DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-1918
Mailing Address - Country:US
Mailing Address - Phone:956-725-3888
Mailing Address - Fax:956-725-3898
Practice Address - Street 1:109 LAKE GENEVA DR
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-1918
Practice Address - Country:US
Practice Address - Phone:956-725-3888
Practice Address - Fax:956-725-3898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010032251E00000X
TX45D1048177291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677968Medicare ID - Type UnspecifiedMEDICARE NUMBER
TX677968Medicare Oscar/Certification