Healthcare Provider Details

I. General information

NPI: 1528243383
Provider Name (Legal Business Name): ELITE HOME HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2007
Last Update Date: 12/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 LION LAKE DR N
PROGRESO LAKES TX
78596-8199
US

IV. Provider business mailing address

1920 LION LAKE DR N
PROGRESO LAKES TX
78596-8199
US

V. Phone/Fax

Practice location:
  • Phone: 956-684-9811
  • Fax:
Mailing address:
  • Phone: 956-684-9811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JESSICA AMANDA LOPEZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 956-684-9811