Healthcare Provider Details

I. General information

NPI: 1801317920
Provider Name (Legal Business Name): PEOPLE WITH IDEAS OF LOVE, LIBERTY, ACCEPTANCE AND RESPECT PILLAR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2017
Last Update Date: 07/06/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6406 MCPHERSON RD STE 2
LAREDO TX
78041-6258
US

IV. Provider business mailing address

6406 MCPHERSON RD STE 2
LAREDO TX
78041-6258
US

V. Phone/Fax

Practice location:
  • Phone: 956-723-7457
  • Fax: 956-704-5155
Mailing address:
  • Phone: 956-723-7457
  • Fax: 956-704-5155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number39843985
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. ARTURO DIAZ
Title or Position: OWNER
Credential:
Phone: 956-723-7457