Provider Demographics
NPI:1881705408
Name:CORAZON HOMECARE, INC.
Entity type:Organization
Organization Name:CORAZON HOMECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR, DON
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELICA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:713-490-3222
Mailing Address - Street 1:4105 CHAPMAN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77009-4229
Mailing Address - Country:US
Mailing Address - Phone:713-490-3222
Mailing Address - Fax:713-490-3555
Practice Address - Street 1:4105 CHAPMAN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009-4229
Practice Address - Country:US
Practice Address - Phone:713-490-3222
Practice Address - Fax:713-490-3555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008970251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX673112Medicare ID - Type UnspecifiedPROVIDER NUMBER