Healthcare Provider Details

I. General information

NPI: 1376619486
Provider Name (Legal Business Name): MI CASA PHC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3907 S SUGAR RD
EDINBURG TX
78539-9888
US

IV. Provider business mailing address

3907 S SUGAR RD
EDINBURG TX
78539-9888
US

V. Phone/Fax

Practice location:
  • Phone: 956-380-2220
  • Fax: 956-384-9234
Mailing address:
  • Phone: 956-380-2220
  • Fax: 956-384-9234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number007650
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: LAURIE CARREON
Title or Position: CEO
Credential:
Phone: 956-380-2220