Provider Demographics
NPI:1598206815
Name:AT HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:AT HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-387-0000
Mailing Address - Street 1:260 S TEXAS BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6191
Mailing Address - Country:US
Mailing Address - Phone:956-387-0000
Mailing Address - Fax:956-387-0012
Practice Address - Street 1:260 S TEXAS BLVD STE 301
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6191
Practice Address - Country:US
Practice Address - Phone:956-387-0000
Practice Address - Fax:956-387-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-20
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011517251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3487365Medicaid