Provider Demographics
NPI:1720534597
Name:MALTOR HEALTHCARE LLC DBA VIDA REAL HOME CARE
Entity Type:Organization
Organization Name:MALTOR HEALTHCARE LLC DBA VIDA REAL HOME CARE
Other - Org Name:VIDA REAL HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:ISABEL
Authorized Official - Last Name:MALTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-320-8008
Mailing Address - Street 1:900 AVENUE C
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-3848
Mailing Address - Country:US
Mailing Address - Phone:830-320-8008
Mailing Address - Fax:833-772-1223
Practice Address - Street 1:900 AVENUE C
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-3848
Practice Address - Country:US
Practice Address - Phone:830-320-8008
Practice Address - Fax:833-772-1223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty