MEDICARE: PRESIDENTE 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	253Z00000X	In Home Supportive Care Agency
2	3747P1801X	Personal Care Attendant
3	251E00000X	Home Health Agency	009247	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	009247	OTHER	TX	HCSSA STATE LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730269671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESIDENTE HOME CARE, INC.

Provider Business Mailing Address
First Line	:	405 NORTH MAIN STREET SUITE 1
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78501-4634
Country	:	US
Telephone Number	:	956-687-6760
Fax Number	:	956-687-6763

Provider Business Practice Location Address
First Line	:	405 NORTH MAIN STREET
Second Line	:	SUITE 1
City	:	MCALLEN
State	:	TX
Zip	:	78501-4634
Country	:	US
Telephone Number	:	956-687-6760
Fax Number	:	956-687-6763

Authorized Official
Title or Position	:	ADMINISTRATOR/PRESIDENT/OWNER
Name	:	MR. ROMEO VALLADARES
Credential	:	R.N.
Telephone Number	:	956-687-6760

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	12/12/2023

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