Healthcare Provider Details

I. General information

NPI: 1336680578
Provider Name (Legal Business Name): AMANECER HEALTH CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 03/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6730 MILE 17 1/2
EDCOUCH TX
78538
US

IV. Provider business mailing address

PO BOX 456
LA VILLA TX
78562-0456
US

V. Phone/Fax

Practice location:
  • Phone: 956-472-4600
  • Fax: 866-620-7006
Mailing address:
  • Phone: 956-472-4600
  • Fax: 866-620-7006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateTX

VIII. Authorized Official

Name: ALICIA ORTIZ
Title or Position: OWNER
Credential:
Phone: 956-472-4600