Provider Demographics
NPI:1699280016
Name:DEL MAR PRIMARY HOME CARE, LLC.
Entity type:Organization
Organization Name:DEL MAR PRIMARY HOME CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-251-2367
Mailing Address - Street 1:PO BOX 1093
Mailing Address - Street 2:
Mailing Address - City:ZAPATA
Mailing Address - State:TX
Mailing Address - Zip Code:78076-1093
Mailing Address - Country:US
Mailing Address - Phone:956-750-3099
Mailing Address - Fax:956-750-3199
Practice Address - Street 1:802 N US HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:ZAPATA
Practice Address - State:TX
Practice Address - Zip Code:78076-3701
Practice Address - Country:US
Practice Address - Phone:956-251-2367
Practice Address - Fax:956-765-8265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-07
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty