Provider Demographics
NPI:1104382738
Name:ABRAZOS DE JESUS HEALTHCARE, LLC
Entity type:Organization
Organization Name:ABRAZOS DE JESUS HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LETICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DE JESUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-793-1888
Mailing Address - Street 1:PO BOX 517
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:TX
Mailing Address - Zip Code:78593
Mailing Address - Country:US
Mailing Address - Phone:956-793-1888
Mailing Address - Fax:
Practice Address - Street 1:804 N COMMERCE
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550
Practice Address - Country:US
Practice Address - Phone:956-793-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health