Healthcare Provider Details

I. General information

NPI: 1184671570
Provider Name (Legal Business Name): CMS HOME HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 07/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 W VILLAGE BLVD SUITE 7
LAREDO TX
78041-2227
US

IV. Provider business mailing address

209 W VILLAGE BLVD SUITE 7
LAREDO TX
78041-2227
US

V. Phone/Fax

Practice location:
  • Phone: 967-753-6701
  • Fax: 956-753-6401
Mailing address:
  • Phone: 967-753-6701
  • Fax: 956-753-6401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number009966
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number012270
License Number StateTX

VIII. Authorized Official

Name: MR. EFRAIN EDUARDO GUTIERREZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 956-753-6701