Provider Demographics
NPI:1053449447
Name:NEW MISSION HOME CARE LLC
Entity Type:Organization
Organization Name:NEW MISSION HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:VELIA
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:915-851-9200
Mailing Address - Street 1:PO BOX 1424
Mailing Address - Street 2:
Mailing Address - City:SAN ELIZARIO
Mailing Address - State:TX
Mailing Address - Zip Code:79849-1424
Mailing Address - Country:US
Mailing Address - Phone:915-851-9200
Mailing Address - Fax:915-851-9207
Practice Address - Street 1:12708 ALAMEDA AVE.
Practice Address - Street 2:
Practice Address - City:CLINT
Practice Address - State:TX
Practice Address - Zip Code:79836-0350
Practice Address - Country:US
Practice Address - Phone:915-851-9200
Practice Address - Fax:915-851-9207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7002738251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX457881Medicare Oscar/Certification