Provider Demographics
NPI:1689691552
Name:A SU SALUD HOME HEALTH, LLC
Entity Type:Organization
Organization Name:A SU SALUD HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHALFANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-928-1400
Mailing Address - Street 1:4311 N 10TH ST STE B4
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3085
Mailing Address - Country:US
Mailing Address - Phone:956-928-1400
Mailing Address - Fax:956-928-1444
Practice Address - Street 1:4311 N 10TH ST STE B4
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3085
Practice Address - Country:US
Practice Address - Phone:956-928-1400
Practice Address - Fax:956-928-1444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010422251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX010422OtherHOME HEALTH LICENSE