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NPI Code Detail

MEDICARE: SU CASA HEALTH CARE SERVICES LLC

MEDICARE: SU CASA HEALTH CARE SERVICES 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
1251E00000XHome Health Agency009044TX

General Provider Information

NPI Number : 1710980040
Entity Type Code : Organization
Provider Name (Legal Business Name) : SU CASA HEALTH CARE SERVICES LLC
Provider Business Mailing Address
First Line : 9220 MCCOMBS ST
Second Line :
City : EL PASO
State : TX
Zip : 79924-7443
Country : US
Telephone Number : 915-781-1882
Fax Number : 915-781-1883
Provider Business Practice Location Address
First Line : 9220 MCCOMBS ST
Second Line :
City : EL PASO
State : TX
Zip : 79924-7443
Country : US
Telephone Number : 915-781-1882
Fax Number : 915-781-1883
Authorized Official
Title or Position : ADM, OWNER
Name : ELVA ELENA BROWN
Credential : RN
Telephone Number : 915-781-1882
Provider Enumeration Date : 05/31/2005
Last Update Date : 10/13/2011

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Directions to “SU CASA HEALTH CARE SERVICES LLC ” Practice Location

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