Provider Demographics
NPI:1144562539
Name:SAN JOSE HEALTH CARE, LLC
Entity Type:Organization
Organization Name:SAN JOSE HEALTH CARE, LLC
Other - Org Name:SAN JOSE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIZONDO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:956-781-3254
Mailing Address - Street 1:207 S CAGE BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-4824
Mailing Address - Country:US
Mailing Address - Phone:956-781-3254
Mailing Address - Fax:956-781-3210
Practice Address - Street 1:207 S CAGE BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-4824
Practice Address - Country:US
Practice Address - Phone:956-781-3254
Practice Address - Fax:956-781-3210
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRECKENRIDGE SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-23
Last Update Date:2013-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health