Provider Demographics
NPI:1255377131
Name:MY SWEET HOME HOME HEALTHCARE, LLC
Entity type:Organization
Organization Name:MY SWEET HOME HOME HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-488-1255
Mailing Address - Street 1:1691 E SAN BENITO ST
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-3401
Mailing Address - Country:US
Mailing Address - Phone:956-488-1255
Mailing Address - Fax:956-487-7988
Practice Address - Street 1:1691 E SAN BENITO ST
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-3401
Practice Address - Country:US
Practice Address - Phone:956-488-1255
Practice Address - Fax:956-487-7988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2007-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008684251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
679408Medicare Oscar/Certification