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Organization
SAN JUAN PRIMARY HOME CARE AGENCY
Active
Organization
SAN JUAN PRIMARY HOME CARE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AURORA JUAREZ (AUTHORIZED OFFICIAL)
(210) 927-7712
Entity
Organization
Contact information
Practice address
545 MOURSUND BLVD, SAN ANTONIO, TX 78221-3938
(210) 927-7712
(210) 927-7713
Mailing address
545 MOURSUND BLVD, SAN ANTONIO, TX 78221-3938
(210) 927-7712
(210) 927-7713
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
007530
TX
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001004434
LTC PROVIDER ID
TX
01
—
001015091
VENDOR
TX
05
—
550026860
—
TX
Enumeration date
02/06/2007
Last updated
02/21/2024
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