Healthcare Provider Details

I. General information

NPI: 1306556402
Provider Name (Legal Business Name): DIVINAS MANOS HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2022
Last Update Date: 11/29/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7109 N BARTLETT AVE STE 204
LAREDO TX
78041-6475
US

IV. Provider business mailing address

7109 N BARTLETT AVE STE 204
LAREDO TX
78041-6475
US

V. Phone/Fax

Practice location:
  • Phone: 956-728-8322
  • Fax: 956-728-8353
Mailing address:
  • Phone: 956-728-8322
  • Fax: 956-728-8353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ARMANDO VILLARREAL
Title or Position: CFO
Credential: RN
Phone: 956-728-8322