Healthcare Provider Details

I. General information

NPI: 1811755697
Provider Name (Legal Business Name): MI RANCHITO PRIMARY HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2024
Last Update Date: 03/07/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

337 E MILE 14 1/2 N
WESLACO TX
78599-2658
US

IV. Provider business mailing address

337 E MILE 14 1/2 N
WESLACO TX
78599-2658
US

V. Phone/Fax

Practice location:
  • Phone: 956-262-2100
  • Fax:
Mailing address:
  • Phone: 956-373-4045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA CAMPOS SALINAS
Title or Position: OWNER
Credential:
Phone: 956-373-4045