Healthcare Provider Details

I. General information

NPI: 1831604503
Provider Name (Legal Business Name): MARIPOSA HOME CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2017
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 W POLK AVE STE 16
PHARR TX
78577-2139
US

IV. Provider business mailing address

1315 W POLK AVE STE 16
PHARR TX
78577-2139
US

V. Phone/Fax

Practice location:
  • Phone: 956-884-7200
  • Fax: 956-884-7202
Mailing address:
  • Phone: 956-884-7200
  • Fax:

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: LAURA GUTIERREZ
Title or Position: CEO
Credential:
Phone: 956-884-7200