Healthcare Provider Details

I. General information

NPI: 1396270914
Provider Name (Legal Business Name): CASA TRINIDAD IN-HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2017
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3315 BURKE RD STE 240-B
PASADENA TX
77504-1827
US

IV. Provider business mailing address

3310 SPACE CENTER BLVD. #121
PASADENA TX
77505-1638
US

V. Phone/Fax

Practice location:
  • Phone: 832-603-5272
  • Fax:
Mailing address:
  • Phone: 832-672-6648
  • Fax: 832-672-6312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MARIA INEZ ALANIZ
Title or Position: OWNER/MANAGER
Credential:
Phone: 956-208-6085