Provider Demographics
NPI:1083814719
Name:MIS AMIGOS ADULT DAY CARE CENTER
Entity Type:Organization
Organization Name:MIS AMIGOS ADULT DAY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:YURIDIA
Authorized Official - Middle Name:F
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-380-6238
Mailing Address - Street 1:2111 W SPRAGUE ST
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-3189
Mailing Address - Country:US
Mailing Address - Phone:956-380-6238
Mailing Address - Fax:956-380-6251
Practice Address - Street 1:2111 W SPRAGUE ST
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3189
Practice Address - Country:US
Practice Address - Phone:956-380-6238
Practice Address - Fax:956-380-6251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118450261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care