Healthcare Provider Details

I. General information

NPI: 1952547143
Provider Name (Legal Business Name): CUIDADO CASERO HOME CARE OF VIRGINIA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2008
Last Update Date: 06/11/2020
Certification Date: 06/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4547 EMPIRE CT
FREDERICKSBURG VA
22408-1949
US

IV. Provider business mailing address

1110 N CARROLL AVE
SOUTHLAKE TX
76092-5306
US

V. Phone/Fax

Practice location:
  • Phone: 540-898-2999
  • Fax: 540-898-2929
Mailing address:
  • Phone: 817-310-1100
  • Fax: 817-310-1197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. CARMEN SANTIAGO
Title or Position: CEO
Credential: DRPH, RN, BSN, ET
Phone: 817-310-1100