Provider Demographics
NPI:1568981520
Name:IMPULSE HOME HEALTH THERAPY LLC
Entity Type:Organization
Organization Name:IMPULSE HOME HEALTH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIO
Authorized Official - Middle Name:
Authorized Official - Last Name:CELEDON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP BCBA
Authorized Official - Phone:956-353-9508
Mailing Address - Street 1:2001 MAYFAIR ST
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-4612
Mailing Address - Country:US
Mailing Address - Phone:956-353-9508
Mailing Address - Fax:866-610-1692
Practice Address - Street 1:901 E REDBUD AVE STE 5A
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4673
Practice Address - Country:US
Practice Address - Phone:956-353-9508
Practice Address - Fax:866-610-1692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health