Healthcare Provider Details

I. General information

NPI: 1467406686
Provider Name (Legal Business Name): HEALING HANDS HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 11/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6510 POLARIS DR. STE. 3
LAREDO TX
78041
US

IV. Provider business mailing address

6510 POLARIS DR. STE. 3
LAREDO TX
78041
US

V. Phone/Fax

Practice location:
  • Phone: 956-727-9111
  • Fax: 956-727-9107
Mailing address:
  • Phone: 956-727-9111
  • Fax: 956-727-9107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number010416
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. IRMA MAYELA CEPEDA
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 956-727-9111