Provider Demographics
NPI:1558671008
Name:UN BUEN AMANECER HOME HEALTH, INC.
Entity Type:Organization
Organization Name:UN BUEN AMANECER HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:R
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-969-1231
Mailing Address - Street 1:2005 E GRIFFIN PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-3222
Mailing Address - Country:US
Mailing Address - Phone:956-969-1231
Mailing Address - Fax:956-973-9046
Practice Address - Street 1:2005 E GRIFFIN PKWY STE B
Practice Address - Street 2:STE 3
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3222
Practice Address - Country:US
Practice Address - Phone:956-969-1231
Practice Address - Fax:956-973-9046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
TX013808251E00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No251E00000XAgenciesHome Health