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General NPI Number Information
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NPI Number | 1265655781
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Entity Type | Organization
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Legal Business Name | MISSION ADULT & SENIOR CARE CENTER PA.
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 03/18/2011
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Provider Practice Location Address
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Address Line | 2121 E GRIFFIN PKWY STE 4
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City | MISSION
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State | TX
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Zip | 78574-3072
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Country | US
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Telephone | 956-581-2770
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Fax | 956-581-7811
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Provider Business Mailing Address
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Address Line | PO BOX 1059
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City | MISSION
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State | TX
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Zip | 78573-0017
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Country | US
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Telephone | 956-581-2770
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Fax | 956-581-7811
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Authorized Official
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Title or Position | SUPERVISOR
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Name | SANDRA L RUGAMA
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Credential |
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Telephone | 956-581-2770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | J4669
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License Number State | TX
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