Provider Demographics
NPI:1306031869
Name:MI HACIENDA ADULT DAY CARE
Entity Type:Organization
Organization Name:MI HACIENDA ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HILDA
Authorized Official - Middle Name:B
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-975-1420
Mailing Address - Street 1:2917 N WESTGATE DR
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78599-4970
Mailing Address - Country:US
Mailing Address - Phone:956-447-8161
Mailing Address - Fax:956-447-8163
Practice Address - Street 1:2917 N WESTGATE DR
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78599
Practice Address - Country:US
Practice Address - Phone:956-447-8161
Practice Address - Fax:956-447-8163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care