Organization
HOSANNA HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LETICIA FERNANDEZ (PRESIDENT)
(512) 731-2335
Entity
Organization
Contact information
Practice address
16533 SE MAIN ST, PORTLAND, OR 97233-4044
(512) 731-2335
(971) 407-3713
Mailing address
13730 RANCH ROAD 620 N APT 112, AUSTIN, TX 78717-1035
(512) 731-2335
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
07/12/2019
Last updated
07/12/2019
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