Provider Demographics
NPI:1326194846
Name:CARECETERA HOME CARE, INC.
Entity Type:Organization
Organization Name:CARECETERA HOME CARE, INC.
Other - Org Name:CARE ETC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-775-6858
Mailing Address - Street 1:711 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-5863
Mailing Address - Country:US
Mailing Address - Phone:830-775-6858
Mailing Address - Fax:830-469-1987
Practice Address - Street 1:711 S MAIN ST
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-5863
Practice Address - Country:US
Practice Address - Phone:830-775-6858
Practice Address - Fax:830-469-1987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008855251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001013320OtherSTATE PHC CONTRACT
TX001016507OtherSTATE PHC CONTRACT