MEDICARE: RGV ATTENDANT SERVICES, 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

General Provider Information

NPI Number	:	1417105354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RGV ATTENDANT SERVICES, LLC

Provider Business Mailing Address
First Line	:	12935 N TROSPER RD
Second Line	:
City	:	MISSION
State	:	TX
Zip	:	78573-0944
Country	:	US
Telephone Number	:	956-240-6605
Fax Number	:	956-581-4053

Provider Business Practice Location Address
First Line	:	4326 TWIN CIR
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78542-7114
Country	:	US
Telephone Number	:	956-240-6605
Fax Number	:	956-581-4053

Authorized Official
Title or Position	:	CHEIF FINANCIAL OFFICER
Name	:	MR. ROBERTO J. RODRIGUEZ
Credential	:	LVN
Telephone Number	:	956-240-6605

Provider Enumeration Date	:	09/04/2008
Last Update Date	:	09/04/2008

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