Provider Demographics
NPI:1700555497
Name:AMOR DIVINO HOME CARE, LLC
Entity type:Organization
Organization Name:AMOR DIVINO HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IRIS
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-272-8823
Mailing Address - Street 1:508 HIDDEN TRCE
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78599-4059
Mailing Address - Country:US
Mailing Address - Phone:956-272-8823
Mailing Address - Fax:
Practice Address - Street 1:508 HIDDEN TRCE
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78599-4059
Practice Address - Country:US
Practice Address - Phone:956-272-8823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health