Provider Demographics
NPI:1275917890
Name:LA FAMILIA PRIMARY HOME CARE LLC
Entity Type:Organization
Organization Name:LA FAMILIA PRIMARY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CERDA
Authorized Official - Suffix:
Authorized Official - Credentials:RT(R)(M)
Authorized Official - Phone:956-206-6479
Mailing Address - Street 1:1502 TEXOMA ST
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78046-5193
Mailing Address - Country:US
Mailing Address - Phone:956-206-6479
Mailing Address - Fax:
Practice Address - Street 1:1502 TEXOMA ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78046-5193
Practice Address - Country:US
Practice Address - Phone:956-206-6479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care