Provider Demographics
NPI:1407229727
Name:GUERRA TRANSITIONS MHT LLC
Entity Type:Organization
Organization Name:GUERRA TRANSITIONS MHT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:GUERRA
Authorized Official - Last Name:VALENCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-441-5964
Mailing Address - Street 1:7418 N 16TH LN
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3244
Mailing Address - Country:US
Mailing Address - Phone:570-441-5964
Mailing Address - Fax:
Practice Address - Street 1:1515 HERITAGE DR
Practice Address - Street 2:SUITE 110
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3256
Practice Address - Country:US
Practice Address - Phone:844-633-4663
Practice Address - Fax:877-489-3949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1646282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX296889302Medicaid
TX165969Medicare UPIN