Provider Demographics
NPI:1194586131
Name:WESTSIDE PRIVATE CARE LLC
Entity type:Organization
Organization Name:WESTSIDE PRIVATE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRAZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-726-8465
Mailing Address - Street 1:724 BLUFF CANYON CIR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-5152
Mailing Address - Country:US
Mailing Address - Phone:915-726-8465
Mailing Address - Fax:
Practice Address - Street 1:724 BLUFF CANYON CIR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-5152
Practice Address - Country:US
Practice Address - Phone:915-726-8465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health