Provider Demographics
NPI:1871951236
Name:BELLOS MOMENTOS HOMECARE INC
Entity type:Organization
Organization Name:BELLOS MOMENTOS HOMECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNGUIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-587-1023
Mailing Address - Street 1:PO BOX 485
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78573-0009
Mailing Address - Country:US
Mailing Address - Phone:956-929-5921
Mailing Address - Fax:844-302-0895
Practice Address - Street 1:1011 W 27TH ST
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78574
Practice Address - Country:US
Practice Address - Phone:956-587-1023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-01
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX377069501Medicaid