Healthcare Provider Details

I. General information

NPI: 1811298524
Provider Name (Legal Business Name): MI MARANATHA HOME HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2010
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4307 N 10TH ST STE A
MCALLEN TX
78504-3030
US

IV. Provider business mailing address

4307 N 10TH ST STE A
MCALLEN TX
78504-3030
US

V. Phone/Fax

Practice location:
  • Phone: 956-683-6219
  • Fax: 956-287-3776
Mailing address:
  • Phone: 956-683-6219
  • Fax: 956-287-3776

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
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: GABRIELA DELEON
Title or Position: ADMINSTRATOR/OWNER
Credential:
Phone: 956-683-6219