La Vida Divina LLC
Nursing Care in Port Isabel, TX. Organization (NPI-2).
NPI number1982247912
StatusActive
Last updated in NPPESOct 15, 2024
Details
- NPI
- 1982247912
- Entity type
- Organization (NPI-2)
- Legal business name
- La Vida Divina LLC
- Organization subpart
- No
- Enumeration date
- Oct 22, 2019
- Certification date
- Oct 15, 2024
- Last updated
- Oct 15, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251J00000X | Nursing Care | – | – | Yes |
| 251E00000X | Home Health | – | – | |
| 3747P1801X | Technician, Personal Care Attendant | – | – |
Practice location
302 E Queen Isabella Blvd Ste CPort Isabel, TX 78578-2407
Phone 512-696-7417 · Fax 956-396-0555
Mailing address
302 E Queen Isabella Blvd Ste CPort Isabel, TX 78578-2407
Phone 512-696-7417 · Fax 956-396-0555
Authorized official
Priscilla Torre
Administrator
5126967417
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