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General NPI Number Information
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NPI Number | 1689610354
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Entity Type | Organization
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Legal Business Name | AMISTAD HOME CARE SERVICES, INC
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 01/30/2013
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Provider Practice Location Address
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Address Line | 1612 E GRIFFIN PKWY
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City | MISSION
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State | TX
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Zip | 78572-3180
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Country | US
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Telephone | 956-584-1139
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Fax | 956-584-1196
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Provider Business Mailing Address
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Address Line | 1612 E GRIFFIN PKWY
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City | MISSION
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State | TX
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Zip | 78572-3180
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Country | US
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Telephone | 956-584-1139
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Fax | 956-584-1196
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIA N TIJERINA
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Credential |
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Telephone | 956-584-1139
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 009175
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License Number State | TX
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