Provider Demographics
NPI:1134527799
Name:RISAS Y RAYONES HOMECARE SERVICES LLC
Entity type:Organization
Organization Name:RISAS Y RAYONES HOMECARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMNISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NOELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAVAZOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-475-3681
Mailing Address - Street 1:6422 S CAGE BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-6931
Mailing Address - Country:US
Mailing Address - Phone:956-475-3681
Mailing Address - Fax:956-502-5485
Practice Address - Street 1:6422 S CAGE BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-6931
Practice Address - Country:US
Practice Address - Phone:956-475-3681
Practice Address - Fax:956-502-5485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-15
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX309624001Medicaid