Provider Demographics
NPI:1588606719
Name:AFFECTIONATE HOME HEALTH, INC.
Entity Type:Organization
Organization Name:AFFECTIONATE HOME HEALTH, INC.
Other - Org Name:AFFECTIONATE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:LARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-428-6100
Mailing Address - Street 1:1816 E HARRISON AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7472
Mailing Address - Country:US
Mailing Address - Phone:956-428-6100
Mailing Address - Fax:956-428-6102
Practice Address - Street 1:1816 E HARRISON AVE
Practice Address - Street 2:SUITE C
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7472
Practice Address - Country:US
Practice Address - Phone:956-428-6100
Practice Address - Fax:956-428-6102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011341251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health