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General NPI Number Information
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NPI Number | 1306064183
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Entity Type | Organization
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Legal Business Name | MELVA GONZALEZ
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1109 N 77 SUNSHINE STRIP
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City | HARLINGEN
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State | TX
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Zip | 78550-8822
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Country | US
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Telephone | 956-245-0035
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Fax | 956-425-9900
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Provider Business Mailing Address
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Address Line | 1109 N 77 SUNSHINE STRIP
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City | HARLINGEN
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State | TX
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Zip | 78550-8822
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Country | US
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Telephone | 956-245-0035
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Fax | 956-425-9900
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | MS. MELVA RUIZ GONZALEZ
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Credential |
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Telephone | 956-245-0035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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