Provider Demographics
NPI:1295487494
Name:REIGNING GRACE PRIMARY HOME CARE, LLC
Entity type:Organization
Organization Name:REIGNING GRACE PRIMARY HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CLAUDIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-339-0311
Mailing Address - Street 1:1409 S 9TH AVE STE 146
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-5527
Mailing Address - Country:US
Mailing Address - Phone:956-339-0311
Mailing Address - Fax:956-443-3509
Practice Address - Street 1:1409 S 9TH AVE STE 146
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5527
Practice Address - Country:US
Practice Address - Phone:956-219-5437
Practice Address - Fax:956-443-3509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing CareGroup - Multi-Specialty