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General NPI Number Information
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NPI Number | 1326324401
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Entity Type | Organization
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Legal Business Name | AGAVE HOME HEALTH LLC
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Dates
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Enumeration Date | 11/02/2011
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 610 E HOLLAND AVE
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City | ALPINE
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State | TX
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Zip | 79830-4830
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Country | US
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Telephone | 432-837-5907
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Fax | 866-523-1745
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Provider Business Mailing Address
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Address Line | 610 EAST HOLLAND AVE.
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City | ALPINE
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State | TX
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Zip | 79830
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Country | US
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Telephone | 432-837-5907
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Fax | 866-523-1745
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER
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Name | ANGELA B JUETT
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Credential |
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Telephone | 432-837-5907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health 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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 015776
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License Number State | TX
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