Healthcare Provider Details

I. General information

NPI: 1972124907
Provider Name (Legal Business Name): MI HOGAR HOME CARE PROVIDER SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2020
Last Update Date: 05/01/2020
Certification Date: 05/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 JACAMAN RD # RP8-D
LAREDO TX
78041-6210
US

IV. Provider business mailing address

1701 JACAMAN RD # RP8-D
LAREDO TX
78041-6210
US

V. Phone/Fax

Practice location:
  • Phone: 956-615-1000
  • Fax: 956-615-1001
Mailing address:
  • Phone: 956-615-1000
  • Fax: 956-615-1001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: ANA GARZA
Title or Position: OWNER
Credential:
Phone: 956-615-1000