Provider Demographics
NPI:1518419217
Name:AMOR Y AMISTAD PRIMARY HOME CARE, LLC.
Entity Type:Organization
Organization Name:AMOR Y AMISTAD PRIMARY HOME CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-624-6807
Mailing Address - Street 1:PO BOX 1858
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78599-1858
Mailing Address - Country:US
Mailing Address - Phone:956-447-0007
Mailing Address - Fax:956-517-2021
Practice Address - Street 1:3514 PALMERO DR
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596
Practice Address - Country:US
Practice Address - Phone:956-447-0007
Practice Address - Fax:956-517-2021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-28
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health