Provider Demographics
NPI:1689462509
Name:ETERNAL HAPPINESS PHC SERVICES LLC
Entity type:Organization
Organization Name:ETERNAL HAPPINESS PHC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DIEGO
Authorized Official - Middle Name:ERIBERTO
Authorized Official - Last Name:BUSTILLOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-400-4068
Mailing Address - Street 1:701 BALTIC AVE
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-7360
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 BALTIC AVE
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-7360
Practice Address - Country:US
Practice Address - Phone:956-400-4068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty