MEDICARE: CANINE FRIENDLY COALITION, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	74-7761	OTHER	TX	CMS CCN

General Provider Information

NPI Number	:	1649550880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANINE FRIENDLY COALITION, INC

Provider Business Mailing Address
First Line	:	1119 MONTANA AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-5509
Country	:	US
Telephone Number	:	915-566-0999
Fax Number	:	915-566-0984

Provider Business Practice Location Address
First Line	:	1119 MONTANA AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-5509
Country	:	US
Telephone Number	:	915-566-0999
Fax Number	:	915-566-0984

Authorized Official
Title or Position	:	CEO
Name	:	MIGUEL VILLANUEVA
Credential	:
Telephone Number	:	915-307-0719

Provider Enumeration Date	:	08/19/2011
Last Update Date	:	01/16/2026

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