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General NPI Number Information
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NPI Number | 1366814949
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Entity Type | Organization
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Legal Business Name | LUNA PRIMARY HOME CARE, LLC
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Dates
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Enumeration Date | 10/22/2015
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Last Update Date | 10/22/2015
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Provider Practice Location Address
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Address Line | 7710 W EXPWY 83 STE B
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City | PALMVIEW
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State | TX
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Zip | 78572-2064
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Country | US
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Telephone | 956-257-4462
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 777
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City | PENITAS
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State | TX
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Zip | 78576-0777
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Country | US
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Telephone | 956-257-4462
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MS. ANITA LUNA
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Credential |
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Telephone | 956-257-4462
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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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