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General NPI Number Information
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NPI Number | 1588606057
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Entity Type | Organization
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Legal Business Name | SAN JOSE HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 06/01/2012
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Provider Practice Location Address
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Address Line | 102 LAKE GENEVA DR
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City | LAREDO
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State | TX
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Zip | 78041-1918
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Country | US
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Telephone | 956-728-8424
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Fax | 956-728-8426
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Provider Business Mailing Address
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Address Line | 102 LAKE GENEVA
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City | LAREDO
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State | TX
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Zip | 78041-6335
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Country | US
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Telephone | 956-728-8424
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Fax | 956-728-8426
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. CLAUDIA G MUNOZ
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Credential | B.A.
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Telephone | 956-728-8424
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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 | 010699
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License Number State | TX
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