Healthcare Provider Details

I. General information

NPI: 1982016564
Provider Name (Legal Business Name): GUADALUPE HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2014
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 W JUAN BALLI RD
PHARR TX
78577-9022
US

IV. Provider business mailing address

112 W JUAN BALLI RD
PHARR TX
78577-9022
US

V. Phone/Fax

Practice location:
  • Phone: 956-783-4900
  • Fax: 956-783-4905
Mailing address:
  • Phone: 956-783-4900
  • Fax: 956-783-4905

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ERIKA GUADALUPE DE LA TORRE
Title or Position: ADMINISTRATOR
Credential:
Phone: 956-783-4900