Provider Demographics
NPI:1629578042
Name:ST FRANCIS PRIMARY HOME CARE, LLC
Entity Type:Organization
Organization Name:ST FRANCIS PRIMARY HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-781-8600
Mailing Address - Street 1:2604 N RAUL LONGORIA RD STE 203
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-4219
Mailing Address - Country:US
Mailing Address - Phone:956-781-8600
Mailing Address - Fax:956-781-8606
Practice Address - Street 1:2604 N RAUL LONGORIA RD STE 203
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589-4219
Practice Address - Country:US
Practice Address - Phone:956-781-8600
Practice Address - Fax:956-781-8606
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAN JUAN DME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1578919882Medicaid