Provider Demographics
NPI:1386243350
Name:AMOR ETERNO PROVIDER SERVICES LLC
Entity type:Organization
Organization Name:AMOR ETERNO PROVIDER SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BLANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-685-5036
Mailing Address - Street 1:355 W ELIZABETH ST
Mailing Address - Street 2:SUITE 111-A
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520
Mailing Address - Country:US
Mailing Address - Phone:956-685-5036
Mailing Address - Fax:956-620-3311
Practice Address - Street 1:355 W ELIZABETH ST STE 111A
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-5608
Practice Address - Country:US
Practice Address - Phone:956-685-5036
Practice Address - Fax:956-620-3311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing CareGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty