Provider Demographics
NPI:1730269671
Name:PRESIDENTE HOME CARE, INC.
Entity type:Organization
Organization Name:PRESIDENTE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROMEO
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLADARES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-687-6760
Mailing Address - Street 1:405 NORTH MAIN STREET SUITE 1
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-4634
Mailing Address - Country:US
Mailing Address - Phone:956-687-6760
Mailing Address - Fax:956-687-6763
Practice Address - Street 1:405 NORTH MAIN STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4634
Practice Address - Country:US
Practice Address - Phone:956-687-6760
Practice Address - Fax:956-687-6763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X, 3747P1801X
TX009247251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX009247OtherHCSSA STATE LICENSE
TX2194474Medicaid