Provider Demographics
NPI:1942437769
Name:HESTIA PRIMARY HOME CARE LLC
Entity Type:Organization
Organization Name:HESTIA PRIMARY HOME CARE LLC
Other - Org Name:HESTIA PRIMARY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CISNEROS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:956-778-8765
Mailing Address - Street 1:1968 S 36TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-8337
Mailing Address - Country:US
Mailing Address - Phone:956-778-8765
Mailing Address - Fax:
Practice Address - Street 1:1968 S 36TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-8337
Practice Address - Country:US
Practice Address - Phone:956-778-8765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care