1821388604 NPI number — CAPROCK HOME HEALTH SERVICES, INC.

Table of content: (NPI 1821388604)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821388604 NPI number — CAPROCK HOME HEALTH SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAPROCK HOME HEALTH SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821388604
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/22/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11180 LA QUINTA PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79936-5221
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-598-6522
Provider Business Mailing Address Fax Number:
915-598-7069

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11180 LA QUINTA PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79936-5221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-598-6522
Provider Business Practice Location Address Fax Number:
915-598-7069
Provider Enumeration Date:
04/13/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MORALES
Authorized Official First Name:
MARTHA
Authorized Official Middle Name:
Authorized Official Title or Position:
C.E.O.
Authorized Official Telephone Number:
806-791-0777

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  002251 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 131060907 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".