MEDICARE: NUEVO HOGAR HOME CARE PROVIDERS LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1083165500
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUEVO HOGAR HOME CARE PROVIDERS LLC

Provider Business Mailing Address
First Line	:	1031 E RIO GRANDE AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-4656
Country	:	US
Telephone Number	:	915-584-2428
Fax Number	:	915-584-1114

Provider Business Practice Location Address
First Line	:	1031 E RIO GRANDE AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-4656
Country	:	US
Telephone Number	:	915-584-2428
Fax Number	:	915-584-1114

Authorized Official
Title or Position	:	AGENCY ADMINISTRATOR
Name	:	ANA MARLENE RIOS
Credential	:
Telephone Number	:	915-584-2429

Provider Enumeration Date	:	10/19/2016
Last Update Date	:	10/19/2016

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