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General NPI Number Information
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NPI Number | 1750460531
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Entity Type | Organization
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Legal Business Name | MI CASA ADULT DAYCARE, INC
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 01/02/2019
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Provider Practice Location Address
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Address Line | 2017 E GRIFFIN PARKWAY
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City | MISSION
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State | TX
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Zip | 78574
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Country | US
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Telephone | 956-584-8484
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Fax | 956-584-9191
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Provider Business Mailing Address
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Address Line | 2017 E GRIFFIN PARKWAY
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City | MISSION
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State | TX
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Zip | 78574
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Country | US
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Telephone | 956-584-8484
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Fax | 956-584-9191
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | YURIDIA ALVAREZ
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Credential |
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Telephone | 956-584-8484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 115995
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License Number State | TX
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