Provider Demographics
NPI:1154467496
Name:LAREDO SKILLED SERVICES, INC.
Entity Type:Organization
Organization Name:LAREDO SKILLED SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-724-4280
Mailing Address - Street 1:2101 S EJIDO AVE
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78046-6750
Mailing Address - Country:US
Mailing Address - Phone:956-724-4280
Mailing Address - Fax:956-724-2263
Practice Address - Street 1:2101 S EJIDO AVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78046-6750
Practice Address - Country:US
Practice Address - Phone:956-724-4280
Practice Address - Fax:956-724-2263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010954251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health