Provider Demographics
NPI:1891145447
Name:ABC PRIMARY HOME CARE SERVICES, LLC
Entity type:Organization
Organization Name:ABC PRIMARY HOME CARE SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCALANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-627-0282
Mailing Address - Street 1:214 N 16TH ST STE 306
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-8463
Mailing Address - Country:US
Mailing Address - Phone:956-627-0282
Mailing Address - Fax:956-627-0358
Practice Address - Street 1:214 N 16TH ST STE 306
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-8463
Practice Address - Country:US
Practice Address - Phone:956-627-0282
Practice Address - Fax:956-627-0358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-14
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX017223253Z00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001029246OtherPHC
TX017223OtherSTATE LICENSE
TX373545801Medicaid