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General NPI Number Information
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NPI Number | 1245604339
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Entity Type | Organization
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Legal Business Name | INFINITE PHC,LLC
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Dates
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Enumeration Date | 11/30/2015
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Last Update Date | 11/30/2015
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Provider Practice Location Address
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Address Line | 301 N KING ST STE 106
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City | ALICE
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State | TX
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Zip | 78332-4761
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Country | US
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Telephone | 361-701-1137
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Fax | 361-453-7483
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Provider Business Mailing Address
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Address Line | 301 N KING ST STE 106
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City | ALICE
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State | TX
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Zip | 78332-4761
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Country | US
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Telephone | 361-701-1137
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Fax | 361-453-7483
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SELINA SOLIZ GONZALEZ
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Credential | LVN
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Telephone | 361-701-1137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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