MEDICARE: CUIDADO CASERO HOME HEALTH CENTRAL, 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	251E00000X	Home Health Agency	00-6793	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033196852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CUIDADO CASERO HOME HEALTH CENTRAL, INC.

Provider Business Mailing Address
First Line	:	1110 N CARROLL AVE
Second Line	:
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-5306
Country	:	US
Telephone Number	:	817-310-1100
Fax Number	:	817-310-1197

Provider Business Practice Location Address
First Line	:	1805 RUTHERFORD LN STE 210
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78754
Country	:	US
Telephone Number	:	512-419-7738
Fax Number	:	512-419-9022

Authorized Official
Title or Position	:	CEO
Name	:	DR. CARMEN SANTIAGO
Credential	:
Telephone Number	:	817-310-1100

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	06/11/2020

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