Provider Demographics
NPI:1174016307
Name:MANO AMIGA PRIMARY HOME CARE, LLC
Entity Type:Organization
Organization Name:MANO AMIGA PRIMARY HOME CARE, LLC
Other - Org Name:MANO AMIGA PRIMARY HOME CARE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:C
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-331-8523
Mailing Address - Street 1:1101 VINE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-4051
Mailing Address - Country:US
Mailing Address - Phone:956-331-8523
Mailing Address - Fax:956-331-8625
Practice Address - Street 1:1101 VINE AVE STE C
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4051
Practice Address - Country:US
Practice Address - Phone:956-331-8523
Practice Address - Fax:956-331-8625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-12
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No251X00000XAgenciesSupports BrokerageGroup - Single Specialty