Provider Demographics
NPI:1033196852
Name:CUIDADO CASERO HOME HEALTH CENTRAL, INC.
Entity Type:Organization
Organization Name:CUIDADO CASERO HOME HEALTH CENTRAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-310-1100
Mailing Address - Street 1:1110 N CARROLL AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-5306
Mailing Address - Country:US
Mailing Address - Phone:817-310-1100
Mailing Address - Fax:817-310-1197
Practice Address - Street 1:1805 RUTHERFORD LN STE 210
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754
Practice Address - Country:US
Practice Address - Phone:512-419-7738
Practice Address - Fax:512-419-9022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00-6793251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0238925-01Medicaid
TX0238925-01Medicaid