Provider Demographics
NPI:1538133855
Name:MATRIX HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:MATRIX HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PERLA
Authorized Official - Middle Name:G
Authorized Official - Last Name:ALVARADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-633-8104
Mailing Address - Street 1:11351 JAMES WATT
Mailing Address - Street 2:BLDG C-400
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936
Mailing Address - Country:US
Mailing Address - Phone:915-633-8104
Mailing Address - Fax:915-633-8105
Practice Address - Street 1:11351 JAMES WATT
Practice Address - Street 2:BLDG C-400
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936
Practice Address - Country:US
Practice Address - Phone:915-633-8104
Practice Address - Fax:915-633-8105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
TX008173251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
679217Medicare PIN