Provider Demographics
NPI:1437331485
Name:FRIENDLY CARE HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:FRIENDLY CARE HOME HEALTH SERVICES LLC
Other - Org Name:FRIENDLY CARE HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-790-9161
Mailing Address - Street 1:6414 MCPHERSON RD STE 2
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6152
Mailing Address - Country:US
Mailing Address - Phone:956-790-9161
Mailing Address - Fax:
Practice Address - Street 1:1812 COMMERCE DR STE 1
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-2886
Practice Address - Country:US
Practice Address - Phone:956-724-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-01
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011873251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX015454OtherSTATE LICENCE
TX015454OtherSTATE LICENCE