Healthcare Provider Details

I. General information

NPI: 1669577359
Provider Name (Legal Business Name): RURAL ECONOMIC ASSISTANCE LEAGUE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 05/12/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 LUCERO ST
ALICE TX
78332-5848
US

IV. Provider business mailing address

301 LUCERO ST
ALICE TX
78332-5848
US

V. Phone/Fax

Practice location:
  • Phone: 361-668-3158
  • Fax: 361-664-9695
Mailing address:
  • Phone: 361-668-3158
  • Fax: 361-664-9695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number001433
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MS. GLORIA RAMOS
Title or Position: EXECUTIVE DIRECTOR
Credential: RN
Phone: 361-668-3158