Provider Demographics
NPI:1245406560
Name:RIO GRANDE VALLEY HOME HEALTH, LLC
Entity Type:Organization
Organization Name:RIO GRANDE VALLEY HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DON/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:FELIPE
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-281-0401
Mailing Address - Street 1:2217 JEREMIAH ST
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-3876
Mailing Address - Country:US
Mailing Address - Phone:956-961-9434
Mailing Address - Fax:956-287-4026
Practice Address - Street 1:2217 JEREMIAH ST
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78542-3876
Practice Address - Country:US
Practice Address - Phone:956-281-0401
Practice Address - Fax:956-281-0402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
TX012146251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747256Medicare Oscar/Certification