Provider Demographics
NPI:1386188480
Name:ETERNAL LOVE HEALTH CARE INC
Entity type:Organization
Organization Name:ETERNAL LOVE HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERASTO
Authorized Official - Middle Name:
Authorized Official - Last Name:URESTE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:956-368-5079
Mailing Address - Street 1:33478 FM 803 STE B2
Mailing Address - Street 2:
Mailing Address - City:LOS FRESNOS
Mailing Address - State:TX
Mailing Address - Zip Code:78566-8305
Mailing Address - Country:US
Mailing Address - Phone:956-368-5079
Mailing Address - Fax:956-516-3580
Practice Address - Street 1:33478 FM 803 STE B2
Practice Address - Street 2:
Practice Address - City:LOS FRESNOS
Practice Address - State:TX
Practice Address - Zip Code:78566-8305
Practice Address - Country:US
Practice Address - Phone:956-368-5079
Practice Address - Fax:956-516-3580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-07
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1386188480Medicaid