Provider Demographics
NPI:1700250800
Name:ANGELES DIVINOS HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:ANGELES DIVINOS HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:C
Authorized Official - Last Name:BURKHOLDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-343-5151
Mailing Address - Street 1:1724 N ED CAREY DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8202
Mailing Address - Country:US
Mailing Address - Phone:956-343-5151
Mailing Address - Fax:956-440-1287
Practice Address - Street 1:1724 N ED CAREY DR
Practice Address - Street 2:SUITE B
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8202
Practice Address - Country:US
Practice Address - Phone:956-343-5151
Practice Address - Fax:956-440-1287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-30
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health