Provider Demographics
NPI:1881028223
Name:A CAPPELLA HOME HEALTH AGENCY LLC
Entity Type:Organization
Organization Name:A CAPPELLA HOME HEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:MERCADO
Authorized Official - Last Name:SERRA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MD
Authorized Official - Phone:817-793-5374
Mailing Address - Street 1:7211 FRONTERA
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-5540
Mailing Address - Country:US
Mailing Address - Phone:817-793-5374
Mailing Address - Fax:
Practice Address - Street 1:7211 FRONTERA
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75054-5540
Practice Address - Country:US
Practice Address - Phone:817-793-5374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health