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Organization
PROVISION HOME CARE SERVICES, LLC
Active
Organization
PROVISION HOME CARE SERVICES, LLC
Active
Other names
Provision Home Care Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARISELA GONZALEZ RN, BSN (DON/ADMINISTRATOR)
(956) 975-9264
Entity
Organization
Contact information
Practice address
617 S TEXAS BLVD, STE A, WESLACO, TX 78596
(956) 854-4518
(956) 854-4488
Mailing address
PO BOX 163, WESLACO, TX 78599-0163
(956) 854-4518
(956) 854-4488
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
017533
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3621534
—
TX
05
—
362153401
—
TX
05
—
362153402
—
TX
Enumeration date
03/24/2016
Last updated
01/30/2022
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