Provider Demographics
NPI:1427078963
Name:AMANECER HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:AMANECER HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:CRUZ
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-968-9672
Mailing Address - Street 1:203 E BUSINESS 83 STE 105 B
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6110
Mailing Address - Country:US
Mailing Address - Phone:956-968-9672
Mailing Address - Fax:956-968-9691
Practice Address - Street 1:203 E BUSINESS 83 STE 105 B
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6110
Practice Address - Country:US
Practice Address - Phone:956-968-9672
Practice Address - Fax:956-968-9691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009662251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX457971Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER