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NPI 1902403645

NPI 1902403645 : JIREH HEALTHCARE SERVICES, LLC. : ALAMO, TX

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General NPI Number Information
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    NPI Number           |    1902403645
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    Entity Type          |    Organization 
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    Legal Business Name  |    JIREH HEALTHCARE SERVICES, LLC. 
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Dates
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    Enumeration Date     |    10/06/2020
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    Last Update Date     |    04/21/2022
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Provider Practice Location Address
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    Address Line         |    537 E. FRONTAGE RD. STE. A 
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    City                 |    ALAMO
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    State                |    TX
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    Zip                  |    78516
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    Country              |    US
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    Telephone            |    956-223-1057
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    Fax                  |    956-517-2215
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Provider Business Mailing Address
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    Address Line         |    537 E. FRONTAGE RD. STE. A 
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    City                 |    ALAMO
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    State                |    TX
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    Zip                  |    78516
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    Country              |    US
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    Telephone            |    956-223-1057
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    Fax                  |    956-517-2215
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     JUAN M. VALLEJO 
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    Credential           |    
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    Telephone            |    956-223-1057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251G00000X
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    Taxonomy Name        |    Community Based Hospice Care Agency
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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        |    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 #3
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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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