Provider Demographics
NPI:1861015356
Name:PALMS HEALTHCARE
Entity Type:Organization
Organization Name:PALMS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:I
Authorized Official - Last Name:BENETO
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:956-239-8631
Mailing Address - Street 1:5205 W STATE HIGHWAY 107 STE B
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-9418
Mailing Address - Country:US
Mailing Address - Phone:956-313-8894
Mailing Address - Fax:956-253-3792
Practice Address - Street 1:5205 W STATE HIGHWAY 107 STE B
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9418
Practice Address - Country:US
Practice Address - Phone:956-313-8894
Practice Address - Fax:956-253-3792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-19
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX418570401Medicaid