Provider Demographics
NPI:1295728996
Name:EL PASO DEL NORTE HOME HEALTH AGENCY, INC.
Entity type:Organization
Organization Name:EL PASO DEL NORTE HOME HEALTH AGENCY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ALTERNATE ADMINISTRATOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CENA
Authorized Official - Suffix:III
Authorized Official - Credentials:RN
Authorized Official - Phone:915-999-5507
Mailing Address - Street 1:PO BOX 3334
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79923-3334
Mailing Address - Country:US
Mailing Address - Phone:915-999-5507
Mailing Address - Fax:
Practice Address - Street 1:1401 MONTANA AVE STE C
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5654
Practice Address - Country:US
Practice Address - Phone:915-534-7521
Practice Address - Fax:915-356-7033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXHH002585251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677689Medicare ID - Type Unspecified