Provider Demographics
NPI:1710748785
Name:ROOTED IN LOVE HEALTH CARE LLC
Entity Type:Organization
Organization Name:ROOTED IN LOVE HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IVETTE
Authorized Official - Middle Name:GUADALUPE
Authorized Official - Last Name:CORDOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-336-4183
Mailing Address - Street 1:441 COLORADO DR
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-5900
Mailing Address - Country:US
Mailing Address - Phone:956-336-4183
Mailing Address - Fax:956-338-5850
Practice Address - Street 1:441 COLORADO DR
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-5900
Practice Address - Country:US
Practice Address - Phone:956-336-4183
Practice Address - Fax:956-338-5850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty