Provider Demographics
NPI:1508197716
Name:CBJI HOME CARE, LLC
Entity Type:Organization
Organization Name:CBJI HOME CARE, LLC
Other - Org Name:AMARA HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:J
Authorized Official - Last Name:TAWIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-283-1550
Mailing Address - Street 1:505 W OWASSA RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-7062
Mailing Address - Country:US
Mailing Address - Phone:956-283-1550
Mailing Address - Fax:
Practice Address - Street 1:505 W OWASSA
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-7062
Practice Address - Country:US
Practice Address - Phone:956-283-1550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-28
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
TX013335315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
671671Medicare Oscar/Certification