Provider Demographics
NPI: | 1912175902 |
---|---|
Name: | HEALTHPROV L.L.C. |
Entity type: | Organization |
Organization Name: | HEALTHPROV L.L.C. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER-CEO |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | MELISSA |
Authorized Official - Middle Name: | C |
Authorized Official - Last Name: | CIGARROA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 956-728-0411 |
Mailing Address - Street 1: | 316 WESTMONT DR |
Mailing Address - Street 2: | |
Mailing Address - City: | LAREDO |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78041-2745 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 956-727-4007 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1505 CALLE DEL NORTE |
Practice Address - Street 2: | #375 |
Practice Address - City: | LAREDO |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78041-6036 |
Practice Address - Country: | US |
Practice Address - Phone: | 956-728-0411 |
Practice Address - Fax: | 956-728-0415 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | HEALTHPROV L.L.C. |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2008-02-13 |
Last Update Date: | 2015-07-02 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | 74-7254 | Other | MEDICARE |
TX | 217846901 | Medicaid |