Provider Demographics
NPI:1306232707
Name:AQUARIO PRIMARY HOME CARE, LLC.
Entity Type:Organization
Organization Name:AQUARIO PRIMARY HOME CARE, LLC.
Other - Org Name:AQUARIO PRIMARY HOME CARE, LLC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-544-7730
Mailing Address - Street 1:950 E ALTON GLOOR BLVD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3936
Mailing Address - Country:US
Mailing Address - Phone:956-544-7730
Mailing Address - Fax:956-621-0700
Practice Address - Street 1:950 E ALTON GLOOR BLVD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-3936
Practice Address - Country:US
Practice Address - Phone:956-544-7730
Practice Address - Fax:956-621-0700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-13
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care