Provider Demographics
NPI:1306846183
Name:EL SOL HOME HEALTH, INC.
Entity type:Organization
Organization Name:EL SOL HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:MONTANO
Authorized Official - Suffix:
Authorized Official - Credentials:MSN
Authorized Official - Phone:520-421-0447
Mailing Address - Street 1:694 S ELLIOT AVE
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85222-4954
Mailing Address - Country:US
Mailing Address - Phone:520-421-0447
Mailing Address - Fax:520-421-0775
Practice Address - Street 1:694 S ELLIOT AVE
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85222-4954
Practice Address - Country:US
Practice Address - Phone:520-421-0447
Practice Address - Fax:520-421-0775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-22
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHHA0175251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ037133Medicare Oscar/Certification