=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912073933
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PROMESA HOME HEALTH, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/28/2006
-----------------------------------------------------
Last Update Date | 11/12/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1005 E 10TH ST STE A&B
-----------------------------------------------------
City | WESLACO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78596-5127
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-994-0370
-----------------------------------------------------
Fax | 956-994-8737
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1005 E 10TH ST STE A&B
-----------------------------------------------------
City | WESLACO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78596-5127
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-994-0370
-----------------------------------------------------
Fax | 956-994-8737
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | SONIA TORRES
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 956-994-0370
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 013769
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------