Organization
GRANDPA & GRANDMA PRIMARY HOME CARE
Active
Other names
Grandpa & Grandma Primary Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN JOSE DE LEON JR. (OWNER)
(956) 589-6813
Entity
Organization
Contact information
Practice address
123 OLD PORT ISABEL RD STE A5, BROWNSVILLE, TX 78521-3542
(956) 554-9829
(956) 554-7336
Mailing address
123 OLD PORT ISABEL RD STE A5, BROWNSVILLE, TX 78521
(956) 589-6813
(956) 554-7336
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
310400000X
Assisted Living Facility
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1032518
—
TX
Enumeration date
02/17/2011
Last updated
07/19/2023
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