Provider Demographics
NPI:1093119570
Name:PRIVILEGE CARE, LLC
Entity Type:Organization
Organization Name:PRIVILEGE CARE, LLC
Other - Org Name:LA TRINIDAD PROVIDER SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ISELA
Authorized Official - Middle Name:
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-271-6161
Mailing Address - Street 1:125 GUADALUPE ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-5215
Mailing Address - Country:US
Mailing Address - Phone:956-271-6161
Mailing Address - Fax:
Practice Address - Street 1:4812 LA VISTA ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-5453
Practice Address - Country:US
Practice Address - Phone:956-271-6161
Practice Address - Fax:956-322-4128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health