Provider Demographics
NPI:1467064113
Name:CRUZ HOMECARE, LLC
Entity Type:Organization
Organization Name:CRUZ HOMECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-600-8770
Mailing Address - Street 1:702 E GRIFFIN PKWY STE 3
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-2931
Mailing Address - Country:US
Mailing Address - Phone:956-600-8770
Mailing Address - Fax:956-600-8701
Practice Address - Street 1:702 E GRIFFIN PKWY STE 3
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-2931
Practice Address - Country:US
Practice Address - Phone:956-600-8770
Practice Address - Fax:956-600-7934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-22
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX415457701Medicaid
TX020180Medicaid