Provider Demographics
NPI:1912073933
Name:PROMESA HOME HEALTH, INC.
Entity type:Organization
Organization Name:PROMESA HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-994-0370
Mailing Address - Street 1:1005 E 10TH ST STE A&B
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-5127
Mailing Address - Country:US
Mailing Address - Phone:956-994-0370
Mailing Address - Fax:956-994-8737
Practice Address - Street 1:1005 E 10TH ST STE A&B
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-5127
Practice Address - Country:US
Practice Address - Phone:956-994-0370
Practice Address - Fax:956-994-8737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2019-11-12
Deactivation Date:2018-04-20
Deactivation Code:
Reactivation Date:2018-04-30
Provider Licenses
StateLicense IDTaxonomies
251E00000X
TX013769251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188506301Medicaid
TX188506301Medicaid