Provider Demographics
NPI:1215246863
Name:SANTANA PRIMARY HOME CARE, INC.
Entity type:Organization
Organization Name:SANTANA PRIMARY HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALTERNATE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALDREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-438-9357
Mailing Address - Street 1:119 EMORY ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-5331
Mailing Address - Country:US
Mailing Address - Phone:210-438-9357
Mailing Address - Fax:210-438-8102
Practice Address - Street 1:119 EMORY ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-5331
Practice Address - Country:US
Practice Address - Phone:210-438-9357
Practice Address - Fax:210-438-8102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X, 251E00000X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001013148Medicaid