Provider Demographics
NPI:1801312749
Name:LITTLE WARRIORS PEDIATRIC HOME CARE LLC
Entity type:Organization
Organization Name:LITTLE WARRIORS PEDIATRIC HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADON
Authorized Official - Prefix:MRS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-458-1859
Mailing Address - Street 1:1409 S 9TH AVE STE 150
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:956-291-3372
Mailing Address - Fax:866-344-5460
Practice Address - Street 1:1409 S 9TH AVE UNIT 150
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5550
Practice Address - Country:US
Practice Address - Phone:956-291-3372
Practice Address - Fax:866-344-5460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-22
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX403095901Medicaid