Provider Demographics
NPI:1629583083
Name:PRO RE NATA HOME HEALTHCARE, LLC
Entity Type:Organization
Organization Name:PRO RE NATA HOME HEALTHCARE, LLC
Other - Org Name:PRO RE NATA HOME HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:MILINI
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-568-7822
Mailing Address - Street 1:7963 M G RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-2131
Mailing Address - Country:US
Mailing Address - Phone:210-568-7822
Mailing Address - Fax:
Practice Address - Street 1:7963 M G RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-2131
Practice Address - Country:US
Practice Address - Phone:210-568-7822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX018134253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care