MEDICARE: COMMUNITY HOME CARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory	45D1048177	TX
2	251E00000X	Home Health Agency	010032	TX

General Provider Information

NPI Number	:	1013023852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HOME CARE, INC.

Provider Business Mailing Address
First Line	:	109 LAKE GENEVA DR
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78041-1918
Country	:	US
Telephone Number	:	956-725-3888
Fax Number	:	956-725-3898

Provider Business Practice Location Address
First Line	:	109 LAKE GENEVA DR
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78041-1918
Country	:	US
Telephone Number	:	956-725-3888
Fax Number	:	956-725-3898

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	CRISTINA GOMEZ
Credential	:	RN, MSN
Telephone Number	:	956-725-3888

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	04/15/2015

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Directions to “COMMUNITY HOME CARE, INC. ” Practice Location

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