MEDICARE: SALAMANCA RESIDENTIAL 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	:	1801024930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALAMANCA RESIDENTIAL HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	1426 BIANCA
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-2369
Country	:	US
Telephone Number	:	956-342-2547
Fax Number	:

Provider Business Practice Location Address
First Line	:	1426 BIANCA
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-2369
Country	:	US
Telephone Number	:	956-342-2547
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MS. MARINA SALAMANCA
Credential	:
Telephone Number	:	956-342-2547

Provider Enumeration Date	:	06/27/2009
Last Update Date	:	06/27/2009

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