Healthcare Provider Details

I. General information

NPI: 1710450747
Provider Name (Legal Business Name): DE LOS ANGELES HOME HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2019
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8318 RIVERBEND CANYON LN
HOUSTON TX
77089-2592
US

IV. Provider business mailing address

8318 RIVERBEND CANYON LN
HOUSTON TX
77089-2592
US

V. Phone/Fax

Practice location:
  • Phone: 281-896-5225
  • Fax: 832-416-5987
Mailing address:
  • Phone: 281-896-5225
  • Fax: 832-416-5987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: AMELIA GOMEZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 281-896-5225