Provider Demographics
NPI:1740222058
Name:CELESTIAL HEALING HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:CELESTIAL HEALING HOME HEALTH CARE, INC.
Other - Org Name:CELESTIAL HEALING HOME HEALTH CARE, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:CAVAZOS
Authorized Official - Suffix:
Authorized Official - Credentials:NONE
Authorized Official - Phone:956-581-4411
Mailing Address - Street 1:3702 N GLASSCOCK RD
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78573-8462
Mailing Address - Country:US
Mailing Address - Phone:956-581-4411
Mailing Address - Fax:956-581-4979
Practice Address - Street 1:3702 N GLASSCOCK RD
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78573-8462
Practice Address - Country:US
Practice Address - Phone:956-581-4411
Practice Address - Fax:956-581-4979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012170251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health