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General NPI Number Information
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NPI Number | 1851682231
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Entity Type | Organization
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Legal Business Name | LIONSITOS PRIMARY HOME CARE, INC.
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Dates
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Enumeration Date | 04/20/2011
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Last Update Date | 07/16/2019
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Provider Practice Location Address
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Address Line | 1506 EISENHOWER DR
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City | LAREDO
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State | TX
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Zip | 78046-5906
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Country | US
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Telephone | 956-583-4620
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Fax | 956-583-4621
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Provider Business Mailing Address
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Address Line | 1506 EISENHOWER DR
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City | LAREDO
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State | TX
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Zip | 78046-5906
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Country | US
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Telephone | 956-523-0429
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Fax | 956-725-1694
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GUADALUPE DELEON III
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Credential |
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Telephone | 956-523-0429
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | TX
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