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NPI 1144947516

NPI 1144947516 : ALIANZA HOMECARE PROVIDER SERVICES LLC : DONNA, TX

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General NPI Number Information
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    NPI Number           |    1144947516
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    Entity Type          |    Organization 
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    Legal Business Name  |    ALIANZA HOMECARE PROVIDER SERVICES LLC 
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Dates
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    Enumeration Date     |    10/26/2022
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    Last Update Date     |    01/24/2023
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Provider Practice Location Address
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    Address Line         |    1513 E BUSINESS HIGHWAY 83 STE 121 
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    City                 |    DONNA
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    State                |    TX
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    Zip                  |    78537-0649
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    Country              |    US
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    Telephone            |    956-420-1299
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 2613 
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    City                 |    CONROE
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    State                |    TX
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    Zip                  |    77305-2613
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    Country              |    US
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    Telephone            |    956-420-1299
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    Fax                  |    
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Authorized Official
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    Title or Position    |    ADMINISTRATOR
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    Name                 |     RUBEN  TREJO 
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    Credential           |    
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    Telephone            |    956-420-1299
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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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Taxonomy #2
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    Taxonomy Code        |    3747P1801X
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    Taxonomy Name        |    Personal Care Attendant
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    License Number       |    
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    License Number State |    
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