Provider Demographics
NPI:1245594969
Name:SANTA FE PRIMARY HOME CARE SERVICES CORPORATION
Entity Type:Organization
Organization Name:SANTA FE PRIMARY HOME CARE SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-639-6025
Mailing Address - Street 1:3465 RUBEN TORRES SR BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-7438
Mailing Address - Country:US
Mailing Address - Phone:956-550-9901
Mailing Address - Fax:956-550-8383
Practice Address - Street 1:3465 RUBEN TORRES SR BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-7438
Practice Address - Country:US
Practice Address - Phone:956-550-9901
Practice Address - Fax:956-550-8383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-27
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXOO1019826Medicaid