Provider Demographics
NPI:1982016564
Name:GUADALUPE HOME CARE INC
Entity Type:Organization
Organization Name:GUADALUPE HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:GUADALUPE
Authorized Official - Last Name:DE LA TORRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-783-4900
Mailing Address - Street 1:112 W JUAN BALLI RD
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-9022
Mailing Address - Country:US
Mailing Address - Phone:956-783-4900
Mailing Address - Fax:956-783-4905
Practice Address - Street 1:112 W JUAN BALLI RD
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-9022
Practice Address - Country:US
Practice Address - Phone:956-783-4900
Practice Address - Fax:956-783-4905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-29
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3486300-01Medicaid