Provider Demographics
NPI:1225401128
Name:CHILDREN'S HOME THERAPY SPECIALISTS, LLC
Entity Type:Organization
Organization Name:CHILDREN'S HOME THERAPY SPECIALISTS, LLC
Other - Org Name:VILLA CHILDREN'S THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GEORGINA
Authorized Official - Middle Name:G
Authorized Official - Last Name:BARRERA
Authorized Official - Suffix:
Authorized Official - Credentials:SLP MS CCP
Authorized Official - Phone:915-307-9289
Mailing Address - Street 1:2267 TRAWOOD DR STE G3
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-3027
Mailing Address - Country:US
Mailing Address - Phone:915-307-9289
Mailing Address - Fax:915-975-8168
Practice Address - Street 1:2267 TRAWOOD DR STE G3
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-3027
Practice Address - Country:US
Practice Address - Phone:915-307-9289
Practice Address - Fax:915-975-8168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-02
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX355721701Medicaid