Healthcare Provider Details
I. General information
NPI: 1801128541
Provider Name (Legal Business Name): SAB SARA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/05/2010
Last Update Date: 02/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4200 W HWY 83
MISSION TX
78572
US
IV. Provider business mailing address
4200 W HWY 83
MISSION TX
78572
US
V. Phone/Fax
- Phone: 956-519-1339
- Fax: 956-519-0150
- Phone: 956-519-1339
- Fax: 956-519-0150
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 311ZA0620X |
| Taxonomy | Adult Care Home Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
SARA
VELA
Title or Position: SECRETARY
Credential:
Phone: 956-821-2886