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General NPI Number Information
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NPI Number | 1689144586
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Entity Type | Organization
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Legal Business Name | MI CASITA HOMECARE, LLC.
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Dates
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Enumeration Date | 12/04/2018
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Last Update Date | 06/30/2021
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Provider Practice Location Address
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Address Line | 610 N. BROADWAY, STE B #3
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City | ELSA
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State | TX
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Zip | 78543
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Country | US
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Telephone | 956-292-2342
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Fax | 956-420-0222
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Provider Business Mailing Address
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Address Line | P.O. BOX 1614
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City | ELSA
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State | TX
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Zip | 78543
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Country | US
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Telephone | 956-567-2342
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Fax | 956-420-0222
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Authorized Official
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Title or Position | CEO
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Name | ELIAZAR RODRIGUEZ
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Credential |
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Telephone | 956-292-6359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number |
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License Number State |
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Taxonomy #2
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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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