=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487821831
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMOR Y PAZ HOME HEALTH SERVICE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/14/2008
-----------------------------------------------------
Last Update Date | 05/14/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4311 NTH 10TH ST SUITE G3
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78504-3350
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-631-0455
-----------------------------------------------------
Fax | 956-631-0463
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4311 NTH 10TH ST SUITE G-3
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78504
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-631-0455
-----------------------------------------------------
Fax | 956-631-0463
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ADMINISTRATOR
-----------------------------------------------------
Name | DIANA CUELLAR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 956-631-0455
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 041770
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------