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General NPI Number Information
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NPI Number | 1518215193
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Entity Type | Organization
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Legal Business Name | INNOVATIVE VALLEY HOME HEALTH LLC
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Dates
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Enumeration Date | 08/29/2012
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Last Update Date | 02/22/2016
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Provider Practice Location Address
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Address Line | 1510 S EXPRESSWAY 83 STE B
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City | HARLINGEN
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State | TX
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Zip | 78550-6302
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Country | US
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Telephone | 956-245-1235
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Fax | 956-440-0856
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Provider Business Mailing Address
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Address Line | 1510 S EXPRESSWAY 83 STE B
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City | HARLINGEN
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State | TX
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Zip | 78550-6302
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Country | US
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Telephone | 956-873-4483
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Fax | 956-440-0856
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Authorized Official
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Title or Position | CEO
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Name | ELEONZETTA BONILLA
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Credential |
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Telephone | 956-245-6050
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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 | 27449
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License Number State | TX
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