Provider Demographics
NPI:1548561798
Name:GOLDEN ANGELS OF HOPE HEALTH CARE, INC.
Entity Type:Organization
Organization Name:GOLDEN ANGELS OF HOPE HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ESPERANZA
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-766-7154
Mailing Address - Street 1:3700 W 5 MILE RD
Mailing Address - Street 2:STE. B
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78574
Mailing Address - Country:US
Mailing Address - Phone:956-766-7153
Mailing Address - Fax:888-814-8706
Practice Address - Street 1:3700 W 5 MILE RD
Practice Address - Street 2:STE. B
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78574
Practice Address - Country:US
Practice Address - Phone:956-766-7153
Practice Address - Fax:888-814-8706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-04
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013811251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX013811OtherSTATE LICENSE NUMBER
TX74-7679OtherMEDICARE PTAN
TX3221897Medicaid