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General NPI Number Information
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NPI Number | 1689028920
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Entity Type | Organization
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Legal Business Name | MI CASA HOSPICE, L.L.C
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Dates
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Enumeration Date | 04/22/2016
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 701 N TEXAS BLVD STE B
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City | ALICE
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State | TX
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Zip | 78332-3883
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Country | US
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Telephone | 361-453-4105
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Fax | 361-664-3901
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Provider Business Mailing Address
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Address Line | PO BOX 4079
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City | ALICE
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State | TX
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Zip | 78333-4079
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Country | US
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Telephone | 361-453-4105
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Fax | 361-664-3900
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Authorized Official
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Title or Position | OWNER
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Name | BLANCA CASTILLO GARCIA
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Credential |
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Telephone | 361-453-4105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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