Provider Demographics
NPI:1063453462
Name:FIVELACINC D/B/A JEREMIAH HOME HEALTH INC
Entity Type:Organization
Organization Name:FIVELACINC D/B/A JEREMIAH HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARISOL
Authorized Official - Middle Name:
Authorized Official - Last Name:SALINAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-668-8833
Mailing Address - Street 1:4307 N 10TH ST STE G2
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3058
Mailing Address - Country:US
Mailing Address - Phone:956-668-8833
Mailing Address - Fax:956-668-8840
Practice Address - Street 1:4307 N 10TH ST STE G2
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3058
Practice Address - Country:US
Practice Address - Phone:956-668-8833
Practice Address - Fax:956-668-8840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010851251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health