Provider Demographics
NPI:1316563653
Name:RINCONCITO EN EL CIELO PRIMARY HOME CARE LLC
Entity Type:Organization
Organization Name:RINCONCITO EN EL CIELO PRIMARY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:YADIRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:AYALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-821-1092
Mailing Address - Street 1:PO BOX 1011
Mailing Address - Street 2:
Mailing Address - City:HIDALGO
Mailing Address - State:TX
Mailing Address - Zip Code:78557-1011
Mailing Address - Country:US
Mailing Address - Phone:956-843-8133
Mailing Address - Fax:
Practice Address - Street 1:709 RAMON AYALA DR
Practice Address - Street 2:
Practice Address - City:HIDALGO
Practice Address - State:TX
Practice Address - Zip Code:78557
Practice Address - Country:US
Practice Address - Phone:956-821-1092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-23
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty