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General NPI Number Information
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NPI Number | 1659110526
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Entity Type | Organization
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Legal Business Name | HOME CARE WELLNESS LLC
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Dates
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Enumeration Date | 05/21/2024
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Last Update Date | 05/21/2024
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Provider Practice Location Address
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Address Line | 4110 BLUEBONNET DR # 1727
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City | STAFFORD
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State | TX
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Zip | 77477-3910
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Country | US
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Telephone | 281-748-5363
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1727
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City | STAFFORD
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State | TX
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Zip | 77497-1727
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICAL
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Name | CARL CUESTA
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Credential | FNP-BC
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Telephone | 281-748-5363
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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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