Provider Demographics
NPI:1902079296
Name:HERMOSA HEALTH CARE
Entity type:Organization
Organization Name:HERMOSA HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MIKSON
Authorized Official - Middle Name:
Authorized Official - Last Name:EHIMIKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-412-0700
Mailing Address - Street 1:1806 PHEASANT DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8728
Mailing Address - Country:US
Mailing Address - Phone:956-412-0700
Mailing Address - Fax:
Practice Address - Street 1:1806 PHEASANT DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8728
Practice Address - Country:US
Practice Address - Phone:956-412-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health