Organization
POR SU GRACIA PRIMARY HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAZMIN MARTINEZ (OWNER/ADMINISTRATOR)
(956) 543-8700
Entity
Organization
Contact information
Practice address
5233 SAGEBRUSH RD, BROWNSVILLE, TX 78526-4522
(956) 543-8700
Mailing address
5233 SAGEBRUSH RD, BROWNSVILLE, TX 78526-4522
(956) 543-8700
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
06/09/2020
Last updated
03/23/2022
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