Provider Demographics
NPI:1144895186
Name:AMBER LOVE PRIMARY HOME CARE
Entity type:Organization
Organization Name:AMBER LOVE PRIMARY HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MANICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONCIVAIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-929-6751
Mailing Address - Street 1:615 E. CANO ST
Mailing Address - Street 2:615 E. CANO ST
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539
Mailing Address - Country:US
Mailing Address - Phone:956-329-1034
Mailing Address - Fax:877-408-9290
Practice Address - Street 1:615 E. CANO ST
Practice Address - Street 2:615 E. CANO ST
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539
Practice Address - Country:US
Practice Address - Phone:956-329-1034
Practice Address - Fax:877-408-9290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health