=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184812802
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMANECER HOME HEALTH CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/09/2007
-----------------------------------------------------
Last Update Date | 05/14/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7108 N CYNTHIA ST
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78504-1932
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-227-4200
-----------------------------------------------------
Fax | 956-630-0005
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 508 W EXPRESSWAY 83
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78501-2953
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-227-4200
-----------------------------------------------------
Fax | 956-630-0005
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ALT. .ADMINISTRATOR
-----------------------------------------------------
Name | CELIA T OJEAGA
-----------------------------------------------------
Credential | RN/MSN
-----------------------------------------------------
Telephone | 956-227-4200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 011598
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------