=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477205250
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SINAI PRIMARY HOME CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/22/2022
-----------------------------------------------------
Last Update Date | 02/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 722 MORGAN BLVD STE K
-----------------------------------------------------
City | HARLINGEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78550-5124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-291-7131
-----------------------------------------------------
Fax | 956-230-1155
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 722 MORGAN BLVD STE K
-----------------------------------------------------
City | HARLINGEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78550-5124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-291-7131
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | LUCIANO OSVALDO ESTRADA JR.
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 956-291-7131
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3747P1801X
-----------------------------------------------------
Taxonomy Name | Personal Care Attendant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------