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NPI Code Detail

MEDICARE: MINNIE D. CRUZ

MEDICARE: MINNIE D. CRUZ
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
13104A0630XAssisted Living Facility (Behavioral Disturbances)117528TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1$$$$$$$$$OTHERTXSOCIAL SECURITY #

General Provider Information

NPI Number : 1871509604
Entity Type Code : Organization
Provider Name (Legal Business Name) : MINNIE D. CRUZ
Provider Business Mailing Address
First Line : 730 COUNTY ROAD 664
Second Line :
City : DEVINE
State : TX
Zip : 78016-4685
Country : US
Telephone Number : 830-665-4801
Fax Number : 830-665-4801
Provider Business Practice Location Address
First Line : 730 COUNTY ROAD 664
Second Line :
City : DEVINE
State : TX
Zip : 78016-4685
Country : US
Telephone Number : 830-665-4801
Fax Number : 830-665-4801
Authorized Official
Title or Position : OWNER
Name : MS. MINNIE DUNCAN CRUZ
Credential :
Telephone Number : 830-665-4801
Provider Enumeration Date : 08/01/2006
Last Update Date : 05/21/2020

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Directions to “MINNIE D. CRUZ ” Practice Location

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