Provider Demographics
NPI: | 1922494434 |
---|---|
Name: | LA BUENA ESPERANZA HOME CARE,LLC |
Entity Type: | Organization |
Organization Name: | LA BUENA ESPERANZA HOME CARE,LLC |
Other - Org Name: | LA BUENA ESPERZNZA HOME CARE |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | CYNTHIA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CASTILLO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | RN |
Authorized Official - Phone: | 361-562-1588 |
Mailing Address - Street 1: | PO BOX 1527 |
Mailing Address - Street 2: | |
Mailing Address - City: | ALICE |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78333-1527 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 361-453-4393 |
Mailing Address - Fax: | 361-453-4354 |
Practice Address - Street 1: | 130 COUNTY ROAD 134 |
Practice Address - Street 2: | |
Practice Address - City: | ALICE |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78332-7709 |
Practice Address - Country: | US |
Practice Address - Phone: | 361-453-4393 |
Practice Address - Fax: | 361-453-4354 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2015-04-10 |
Last Update Date: | 2015-04-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 251E00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health |