Provider Demographics
NPI:1811648264
Name:AT HOME GROUP LLC
Entity type:Organization
Organization Name:AT HOME GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:URIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-892-3880
Mailing Address - Street 1:444 EXECUTIVE CENTER BLVD STE 123
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-1031
Mailing Address - Country:US
Mailing Address - Phone:915-204-7776
Mailing Address - Fax:
Practice Address - Street 1:444 EXECUTIVE CENTER BLVD STE 123
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-1031
Practice Address - Country:US
Practice Address - Phone:915-204-7776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health