Organization
FIDELITY HOME CARE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALEEN GUZMAN (ADMINISTRATOR)
(210) 716-7416
Entity
Organization
Contact information
Practice address
403 JUNIPER ST, SAN ANTONIO, TX 78223-4376
(210) 716-7416
(184) 569-8396
Mailing address
403 JUNIPER ST, SAN ANTONIO, TX 78223-4376
(210) 716-7416
(184) 569-8396
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
016050
TX
253Z00000X
In Home Supportive Care Agency
Primary
016050
TX
347C00000X
Private Vehicle
016050
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
341931901
—
TX
Enumeration date
07/07/2014
Last updated
11/09/2015
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