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NPI 1881496800

NPI 1881496800 : CENNTRIQUE HOMECARE AGENCY LLC : SAN ANTONIO, TX

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General NPI Number Information
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    NPI Number           |    1881496800
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    Entity Type          |    Organization 
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    Legal Business Name  |    CENNTRIQUE HOMECARE AGENCY LLC 
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Dates
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    Enumeration Date     |    03/27/2025
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    Last Update Date     |    03/27/2025
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Provider Practice Location Address
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    Address Line         |    10802 MERRICK RUN 
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78254-2690
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    Country              |    US
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    Telephone            |    210-992-3220
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    Fax                  |    210-985-0588
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Provider Business Mailing Address
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    Address Line         |    10802 MERRICK RUN 
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78254-2690
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    Country              |    US
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    Telephone            |    210-992-3220
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    Fax                  |    210-985-0588
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     CASSANDRA  NGONG 
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    Credential           |    
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    Telephone            |    210-992-3220
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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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