Healthcare Provider Details

I. General information

NPI: 1588842231
Provider Name (Legal Business Name): FRIENDLY CARE PRIMARY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2319 CHIHUAHUA ST STE 1
LAREDO TX
78043-3704
US

IV. Provider business mailing address

2319 CHIHUAHUA ST STE 1
LAREDO TX
78043-3704
US

V. Phone/Fax

Practice location:
  • Phone: 956-753-6040
  • Fax: 956-753-6850
Mailing address:
  • Phone: 956-753-6040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number011880
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARTHA SANDERSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 956-753-6040