Provider Demographics
NPI:1275114399
Name:LEE'S PRIMARY HOME CARE, INC.
Entity Type:Organization
Organization Name:LEE'S PRIMARY HOME CARE, INC.
Other - Org Name:LEE'S PRIMARY HOME CARE, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIBEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LOS SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-956-5337
Mailing Address - Street 1:108 N JACKSON RD STE 23
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-3694
Mailing Address - Country:US
Mailing Address - Phone:844-956-5337
Mailing Address - Fax:956-338-5801
Practice Address - Street 1:108 N JACKSON RD STE 23
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78541-3694
Practice Address - Country:US
Practice Address - Phone:844-956-5337
Practice Address - Fax:956-338-5801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-20
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Single Specialty