Organization Name: | BUENA VIDA PRIMARY HOME CARE |
NPI Number: | 1194118281 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROSA ELIA MARTINEZ (OWNER) |
Mailing Address: | 3116 E 14th St Brownsville |
State: | TX US |
Postal Code: | 785213316 |
Phone Number: | 9565461115 |
Fax Number: | 9565461104 |
NPI Enumeration Date: | 03/12/2015 |
NPI Last Update Date: | 07/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | In Home Supportive Care |
Taxonomy Specialization: | |
Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |