Healthcare Provider Details

I. General information

NPI: 1619108305
Provider Name (Legal Business Name): MORNINGSTAR SPECIAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2009
Last Update Date: 07/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 JENNIFER ST
DONNA TX
78537-9633
US

IV. Provider business mailing address

102 JENNIFER ST
DONNA TX
78537-9633
US

V. Phone/Fax

Practice location:
  • Phone: 956-905-0419
  • Fax:
Mailing address:
  • Phone: 956-905-0419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. ESMERALDA MUNOZ
Title or Position: OWNER
Credential:
Phone: 956-905-0419