MEDICARE: CON GRACIA HEALTHCARE, 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1740718097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CON GRACIA HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	3307 N MCCOLL RD STE B
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78501-5536
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3307 N MCCOLL RD STE B
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78501-5536
Country	:	US
Telephone Number	:	956-661-0000
Fax Number	:	956-661-0001

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	GRACIELA GRACIA
Credential	:
Telephone Number	:	956-661-0000

Provider Enumeration Date	:	05/31/2017
Last Update Date	:	05/31/2017

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