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NPI 1295591444

NPI 1295591444 : MIS AMORES PHC LLC : EDINBURG, TX

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General NPI Number Information
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    NPI Number           |    1295591444
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    Entity Type          |    Organization 
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    Legal Business Name  |    MIS AMORES PHC LLC 
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Dates
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    Enumeration Date     |    02/26/2024
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    Last Update Date     |    02/26/2024
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Provider Practice Location Address
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    Address Line         |    1916 EZEKIEL ST 
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    City                 |    EDINBURG
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    State                |    TX
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    Zip                  |    78542-5594
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    Country              |    US
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    Telephone            |    956-342-5178
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1916 EZEKIEL ST 
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    City                 |    EDINBURG
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    State                |    TX
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    Zip                  |    78542-5594
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO/OWNER
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    Name                 |     NORA  JASSO 
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    Credential           |    
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    Telephone            |    956-342-5178
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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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