Provider Demographics
NPI:1598398315
Name:ABUELITOS PRIMARY HOME CARE LLC
Entity Type:Organization
Organization Name:ABUELITOS PRIMARY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-739-0516
Mailing Address - Street 1:122 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-4848
Mailing Address - Country:US
Mailing Address - Phone:956-739-0516
Mailing Address - Fax:956-386-9927
Practice Address - Street 1:122 E PARK AVE
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-4848
Practice Address - Country:US
Practice Address - Phone:956-739-0516
Practice Address - Fax:956-386-9927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-20
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care