Provider Demographics
NPI:1467960765
Name:RAYO DE LUZ FAMILY HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:RAYO DE LUZ FAMILY HOME HEALTH CARE, LLC
Other - Org Name:RAYO DE LUZ FAMILY HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-827-9315
Mailing Address - Street 1:309 S BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:HIDALGO
Mailing Address - State:TX
Mailing Address - Zip Code:78557-2806
Mailing Address - Country:US
Mailing Address - Phone:956-827-9315
Mailing Address - Fax:
Practice Address - Street 1:309 S BRIDGE ST
Practice Address - Street 2:
Practice Address - City:HIDALGO
Practice Address - State:TX
Practice Address - Zip Code:78557-2806
Practice Address - Country:US
Practice Address - Phone:956-827-9315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-21
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty