1487838397 NPI number — SEASONS HOME HEALTH LLC

Table of content: (NPI 1487838397)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487838397 NPI number — SEASONS HOME HEALTH LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SEASONS HOME HEALTH LLC
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:
1487838397
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/24/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5460 PAREDES LINE RD STE 205
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROWNSVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78526-9741
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-621-0949
Provider Business Mailing Address Fax Number:
888-844-4752

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
184 VISTA DEL GOLF
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROWNSVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-621-0949
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/27/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GARCIA
Authorized Official First Name:
MARINA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR/OWNER
Authorized Official Telephone Number:
956-621-0949

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  011559 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3747P1801X , with the licence number: 011559 , 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)