Healthcare Provider Details

I. General information

NPI: 1891021317
Provider Name (Legal Business Name): GLOWING HEARTS HOME HEALTH, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2009
Last Update Date: 10/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4325 N 23RD ST STE A
MCALLEN TX
78504-4169
US

IV. Provider business mailing address

PO BOX 3131
EDINBURG TX
78540-3131
US

V. Phone/Fax

Practice location:
  • Phone: 956-316-1700
  • Fax: 956-317-1702
Mailing address:
  • Phone: 956-316-1700
  • Fax: 956-316-1702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. LUCIA ELIZONDO
Title or Position: OWNER/LVN
Credential: LVN
Phone: 956-638-1342