Provider Demographics
NPI:1194889584
Name:ELDERCARE HOME HEALTH & HOSPICE
Entity type:Organization
Organization Name:ELDERCARE HOME HEALTH & HOSPICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXCECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-399-7060
Mailing Address - Street 1:PO BOX 2026
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-0054
Mailing Address - Country:US
Mailing Address - Phone:956-399-7060
Mailing Address - Fax:956-361-4576
Practice Address - Street 1:175 E ROBERTSON ST
Practice Address - Street 2:STE. D
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-3859
Practice Address - Country:US
Practice Address - Phone:956-399-7060
Practice Address - Fax:956-361-4576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0045915332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0173239-01Medicaid
TX0173239-01Medicaid