Provider Demographics
NPI:1710915301
Name:A & E HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:A & E HEALTH SERVICES, INC.
Other - Org Name:NEW LIFE HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLI DOMINGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-464-7741
Mailing Address - Street 1:2115 LOTT RD
Mailing Address - Street 2:
Mailing Address - City:DONNA
Mailing Address - State:TX
Mailing Address - Zip Code:78537-5633
Mailing Address - Country:US
Mailing Address - Phone:956-464-7741
Mailing Address - Fax:956-464-0007
Practice Address - Street 1:2115 LOTT RD
Practice Address - Street 2:
Practice Address - City:DONNA
Practice Address - State:TX
Practice Address - Zip Code:78537-5633
Practice Address - Country:US
Practice Address - Phone:956-464-7741
Practice Address - Fax:956-464-0007
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A & E HEALTH SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-30
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009347251E00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000124000Medicaid
TX0000690500Medicaid
TX001012653Medicaid
TX009347Medicaid
TX024907002OtherTPI
TX45D0902748Medicaid