Healthcare Provider Details

I. General information

NPI: 1609126234
Provider Name (Legal Business Name): EYIA SENIOR CARE ON THE GO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2012
Last Update Date: 09/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 MANN ST STE 702
CORPUS CHRISTI TX
78401-2050
US

IV. Provider business mailing address

400 MANN ST STE 702
CORPUS CHRISTI TX
78401-2050
US

V. Phone/Fax

Practice location:
  • Phone: 361-561-6266
  • Fax: 361-561-6269
Mailing address:
  • Phone: 361-561-6266
  • Fax: 361-561-6269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. MICHELE ELIZABETH SEAY
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 361-561-6266