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General NPI Number Information
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NPI Number | 1740055516
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Entity Type | Organization
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Legal Business Name | SANTA ROSA PRIMARY HOME CARE
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Dates
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Enumeration Date | 11/21/2023
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Last Update Date | 12/19/2023
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Provider Practice Location Address
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Address Line | 6985 LAGUNA DE PALMAS DR
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City | BROWNSVILLE
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State | TX
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Zip | 78526-6671
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Country | US
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Telephone | 956-338-9885
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Fax | 956-561-4419
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Provider Business Mailing Address
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Address Line | 6985 LAGUNA DE PALMAS DR
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City | BROWNSVILLE
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State | TX
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Zip | 78526-6671
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Country | US
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Telephone | 956-338-9885
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Fax | 956-561-4419
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. VERONICA LOPEZ
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Credential |
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Telephone | 956-338-9885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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