Provider Demographics
NPI:1346282969
Name:NINE LAC INC
Entity Type:Organization
Organization Name:NINE LAC INC
Other - Org Name:ALL CARE HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-583-2495
Mailing Address - Street 1:919 N SLABAUGH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-3728
Mailing Address - Country:US
Mailing Address - Phone:956-583-2495
Mailing Address - Fax:956-583-2490
Practice Address - Street 1:919 E SLABAUGH
Practice Address - Street 2:SUITE B
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78512
Practice Address - Country:US
Practice Address - Phone:956-583-2495
Practice Address - Fax:956-583-2490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010949251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679712Medicare Oscar/Certification