MEDICARE: RIO GRANDE VALLEY HOME HEALTH, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency
2	251E00000X	Home Health Agency	012146	TX

General Provider Information

NPI Number	:	1245406560
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIO GRANDE VALLEY HOME HEALTH, LLC

Provider Business Mailing Address
First Line	:	2217 JEREMIAH ST
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78542-3876
Country	:	US
Telephone Number	:	956-961-9434
Fax Number	:	956-287-4026

Provider Business Practice Location Address
First Line	:	2217 JEREMIAH ST
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78542-3876
Country	:	US
Telephone Number	:	956-281-0401
Fax Number	:	956-281-0402

Authorized Official
Title or Position	:	DON/ADMINISTRATOR
Name	:	MR. VICTOR FELIPE GONZALEZ
Credential	:	RN
Telephone Number	:	956-281-0401

Provider Enumeration Date	:	05/06/2008
Last Update Date	:	02/13/2020

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