Provider Demographics
NPI:1679709794
Name:LUZ Y VIDA HOME HEALTH, INC
Entity Type:Organization
Organization Name:LUZ Y VIDA HOME HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:INDIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:VASQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-960-0293
Mailing Address - Street 1:4313 G4 N 10TH
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504
Mailing Address - Country:US
Mailing Address - Phone:956-960-0293
Mailing Address - Fax:956-702-8738
Practice Address - Street 1:4313 N 10TH ST
Practice Address - Street 2:G4
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3061
Practice Address - Country:US
Practice Address - Phone:956-960-0293
Practice Address - Fax:956-702-8738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health