Provider Demographics
NPI:1265063796
Name:NUEVO DESTINO PRIMARY HOME CARE LLC
Entity type:Organization
Organization Name:NUEVO DESTINO PRIMARY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:CESAR
Authorized Official - Last Name:YANEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:956-551-4729
Mailing Address - Street 1:1401 E CROCKETT AVE
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8885
Mailing Address - Country:US
Mailing Address - Phone:956-496-2755
Mailing Address - Fax:956-496-2756
Practice Address - Street 1:722 MORGAN BLVD STE R
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-5124
Practice Address - Country:US
Practice Address - Phone:956-496-2755
Practice Address - Fax:956-496-2756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty