Healthcare Provider Details

I. General information

NPI: 1720333669
Provider Name (Legal Business Name): A DREAM COME TRUE HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2012
Last Update Date: 01/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1709 S 77 SUNSHINESTRIP SUITE B
HARLINGEN TX
78550-8121
US

IV. Provider business mailing address

1709 S 77 SUNSHINESTRIP SUITE B
HARLINGEN TX
78550-8121
US

V. Phone/Fax

Practice location:
  • Phone: 956-752-3716
  • Fax: 956-421-5970
Mailing address:
  • Phone: 956-752-3716
  • Fax: 956-421-5970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HANNAH GUILLEN
Title or Position: OWNER
Credential:
Phone: 956-752-3716