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General NPI Number Information
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NPI Number | 1871942037
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Entity Type | Organization
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Legal Business Name | HEAVENLY GRACE OURANIOS, INC.
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Dates
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Enumeration Date | 06/08/2016
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Last Update Date | 10/19/2016
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Provider Practice Location Address
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Address Line | 2308 VIOLA ST
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City | MISSION
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State | TX
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Zip | 78574-7922
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Country | US
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Telephone | 956-854-4386
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Fax | 956-854-4383
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Provider Business Mailing Address
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Address Line | 620 S TEXAS BLVD STE D
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City | WESLACO
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State | TX
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Zip | 78596-4241
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Country | US
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Telephone | 956-854-4386
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Fax | 956-854-4383
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Authorized Official
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Title or Position | CEO
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Name | NORA E MARTINEZ
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Credential | LVN
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Telephone | 956-854-4386
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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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