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General NPI Number Information
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NPI Number | 1205321791
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Entity Type | Organization
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Legal Business Name | FAITH PRIMARY HOME CARE , LLC
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Dates
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Enumeration Date | 06/27/2018
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Last Update Date | 06/27/2018
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Provider Practice Location Address
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Address Line | 813 EL GATO RD
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City | ALAMO
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State | TX
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Zip | 78516-4124
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Country | US
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Telephone | 956-451-7254
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Fax | 888-559-7871
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Provider Business Mailing Address
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Address Line | 813 EL GATO RD
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City | ALAMO
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State | TX
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Zip | 78516-4124
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Country | US
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Telephone | 956-451-7254
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Fax | 888-559-7871
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Authorized Official
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Title or Position | OWNER
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Name | LYDIA D SANDOVAL
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Credential |
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Telephone | 956-451-7254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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