Provider Demographics
NPI:1255203915
Name:AGUA VIVA HOME CARE LLC
Entity type:Organization
Organization Name:AGUA VIVA HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ONEYDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-230-6670
Mailing Address - Street 1:56 LOS NIETOS RD STE B
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-6164
Mailing Address - Country:US
Mailing Address - Phone:956-230-6670
Mailing Address - Fax:956-263-1497
Practice Address - Street 1:56 LOS NIETOS RD STE B
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-6164
Practice Address - Country:US
Practice Address - Phone:956-230-6670
Practice Address - Fax:956-263-1479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care