Healthcare Provider Details

I. General information

NPI: 1336312123
Provider Name (Legal Business Name): MAS QUE AMIGOS HOME HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2008
Last Update Date: 04/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 LORENA CT
DONNA TX
78537-9529
US

IV. Provider business mailing address

902 LORENA CT
DONNA TX
78537-9529
US

V. Phone/Fax

Practice location:
  • Phone: 956-472-3080
  • Fax: 956-464-1248
Mailing address:
  • Phone: 956-472-3080
  • Fax: 956-464-1248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number011226
License Number StateTX

VIII. Authorized Official

Name: MRS. EVERLINDA GALLEGOS
Title or Position: ADMINISTRATOR
Credential:
Phone: 956-472-3080