=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700254190
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARING HEARTS OF EL PASO HOME CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/02/2015
-----------------------------------------------------
Last Update Date | 11/19/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6501 BOEING DR STE H5
-----------------------------------------------------
City | EL PASO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79925-1085
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-307-5044
-----------------------------------------------------
Fax | 915-307-3927
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4997 BALLINGER DR
-----------------------------------------------------
City | EL PASO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79924-1137
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-307-5044
-----------------------------------------------------
Fax | 915-307-3927
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | VERONICA WILLIAMS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 915-329-2649
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------