Provider Demographics
NPI:1659473783
Name:FALCONCITOS HEALTH CARE, INC
Entity Type:Organization
Organization Name:FALCONCITOS HEALTH CARE, INC
Other - Org Name:LVN HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALVARO
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-716-1500
Mailing Address - Street 1:2544 CENTRAL PALM DR
Mailing Address - Street 2:STE 102
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582
Mailing Address - Country:US
Mailing Address - Phone:956-716-1500
Mailing Address - Fax:956-716-1554
Practice Address - Street 1:2544 CENTRAL PALM DR
Practice Address - Street 2:STE 102
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582
Practice Address - Country:US
Practice Address - Phone:956-716-1500
Practice Address - Fax:956-716-1554
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FALCONCITOS HEALTH CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-01
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747045Medicare Oscar/Certification