Healthcare Provider Details

I. General information

NPI: 1316535677
Provider Name (Legal Business Name): LAS BRISAS HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2021
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 DONNA RD
PALMVIEW TX
78572-7941
US

IV. Provider business mailing address

PO BOX 721004
MCALLEN TX
78504
US

V. Phone/Fax

Practice location:
  • Phone: 956-424-6317
  • Fax: 956-552-7447
Mailing address:
  • Phone: 956-904-5117
  • Fax: 956-338-5657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOHOAN CARLOS MORENO
Title or Position: CEO
Credential:
Phone: 956-424-6317