Provider Demographics
NPI:1912065236
Name:AVIDA HEALTH CARE, INC.
Entity Type:Organization
Organization Name:AVIDA HEALTH CARE, INC.
Other - Org Name:AVIDA HOME HEALTH, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELSA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:VELAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-493-4514
Mailing Address - Street 1:10502 TOMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7812
Mailing Address - Country:US
Mailing Address - Phone:915-532-8432
Mailing Address - Fax:915-351-8432
Practice Address - Street 1:10502 TOMWOOD AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7812
Practice Address - Country:US
Practice Address - Phone:915-532-8432
Practice Address - Fax:915-351-8432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747056Medicare PIN