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General NPI Number Information
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NPI Number | 1013023852
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Entity Type | Organization
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Legal Business Name | COMMUNITY HOME CARE, INC.
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 109 LAKE GENEVA DR
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City | LAREDO
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State | TX
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Zip | 78041-1918
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Country | US
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Telephone | 956-725-3888
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Fax | 956-725-3898
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Provider Business Mailing Address
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Address Line | 109 LAKE GENEVA DR
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City | LAREDO
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State | TX
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Zip | 78041-1918
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Country | US
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Telephone | 956-725-3888
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Fax | 956-725-3898
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CRISTINA GOMEZ
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Credential | RN, MSN
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Telephone | 956-725-3888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 45D1048177
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 010032
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License Number State | TX
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