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General NPI Number Information
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NPI Number | 1114158334
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Entity Type | Organization
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Legal Business Name | ADONAI PRIMARY HOME CARE
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Dates
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Enumeration Date | 08/05/2009
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Last Update Date | 08/05/2009
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Provider Practice Location Address
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Address Line | 2045 WOODSTONE DR
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City | BROWNSVILLE
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State | TX
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Zip | 78526-6936
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Country | US
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Telephone | 956-346-3463
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Fax | 956-838-0804
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Provider Business Mailing Address
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Address Line | 2045 WOODSTONE DR
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City | BROWNSVILLE
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State | TX
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Zip | 78526-6936
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Country | US
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Telephone | 956-346-3463
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Fax | 956-838-0804
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JOSE ANTONIO GARZA JR.
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Credential |
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Telephone | 956-346-3463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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