Provider Demographics
NPI:1528456621
Name:LA RED HEALTH CARE
Entity type:Organization
Organization Name:LA RED HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:MAGALI
Authorized Official - Middle Name:
Authorized Official - Last Name:TELLEZ BLANCAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-709-5072
Mailing Address - Street 1:23659 SAULSBURY LN
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-6388
Mailing Address - Country:US
Mailing Address - Phone:757-709-5072
Mailing Address - Fax:302-856-1747
Practice Address - Street 1:23659 SAULSBURY LN
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-6388
Practice Address - Country:US
Practice Address - Phone:757-709-5072
Practice Address - Fax:302-856-1747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-26
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL2-0012396251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare