MEDICARE: NUESTRO LINDO HOGAR, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1568809648
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUESTRO LINDO HOGAR, LLC

Provider Business Mailing Address
First Line	:	709 ANGELITA DR STE D
Second Line	:
City	:	WESLACO
State	:	TX
Zip	:	78596-5281
Country	:	US
Telephone Number	:	956-351-5139
Fax Number	:

Provider Business Practice Location Address
First Line	:	709 ANGELITA DR STE D
Second Line	:
City	:	WESLACO
State	:	TX
Zip	:	78596-5281
Country	:	US
Telephone Number	:	956-351-5139
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. SYLVIA SALINAS
Credential	:
Telephone Number	:	956-498-8055

Provider Enumeration Date	:	05/29/2013
Last Update Date	:	05/29/2013

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