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General NPI Number Information
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NPI Number | 1912101023
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Entity Type | Organization
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Legal Business Name | NUESTRO SAGRADO CORAZON PRIMARY HOME CARE, INC.
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 11/19/2020
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Provider Practice Location Address
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Address Line | 4811 S JACKSON RD
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City | EDINBURG
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State | TX
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Zip | 78539-9793
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Country | US
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Telephone | 956-627-3434
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Fax | 956-627-3699
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Provider Business Mailing Address
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Address Line | 4811 S JACKSON RD
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City | EDINBURG
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State | TX
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Zip | 78539-9793
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Country | US
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Telephone | 956-627-3434
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Fax | 956-627-3699
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Authorized Official
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Title or Position | ADMINISTRATOR/SIGNING AUTHORITY
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Name | MRS. ANA MARIA HERNANDEZ
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Credential |
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Telephone | 956-968-9828
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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 | 010559
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License Number State | TX
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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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