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General NPI Number Information
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NPI Number | 1992791123
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Entity Type | Organization
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Legal Business Name | AMISTAD HOMECARE, INC
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Dates
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Enumeration Date | 09/22/2005
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 613 NW LOOP 410 STE 630
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City | SAN ANTONIO
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State | TX
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Zip | 78216-5507
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Country | US
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Telephone | 210-474-0037
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Fax | 210-474-0067
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Provider Business Mailing Address
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Address Line | 613 NW LOOP 410 STE 630
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City | SAN ANTONIO
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State | TX
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Zip | 78216-5507
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Country | US
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Telephone | 210-474-0037
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Fax | 210-474-0067
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | RAMONA DIEGO
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Credential |
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Telephone | 210-474-0037
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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 | 008287
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License Number State | TX
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