Organization
AMAZING GRACE PRIMARY HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAVIER C CAVAZOS (ADMINISTRATOR)
(956) 456-6422
Entity
Organization
Contact information
Practice address
220 E OCEAN BLVD, LOS FRESNOS, TX 78566-3227
(956) 233-1718
Mailing address
220 E OCEAN BLVD, LOS FRESNOS, TX 78566-3227
(956) 233-1718
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
05/09/2012
Last updated
03/21/2019
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