Healthcare Provider Details

I. General information

NPI: 1124208368
Provider Name (Legal Business Name): VERGE PRIMARY HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2007
Last Update Date: 11/16/2020
Certification Date: 11/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4622 S. CLOSNER BLVD
EDINBURG TX
78539-7279
US

IV. Provider business mailing address

4622 S. CLOSNER BLVD
EDINBURG TX
78539-7279
US

V. Phone/Fax

Practice location:
  • Phone: 956-287-8585
  • Fax: 956-287-8586
Mailing address:
  • Phone: 956-287-8585
  • Fax: 956-287-8586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MR. ONDER ARI
Title or Position: CEO
Credential:
Phone: 956-287-8585