Provider Demographics
NPI:1437664307
Name:LA PALMA PROVIDER SERVICES, LLC.
Entity Type:Organization
Organization Name:LA PALMA PROVIDER SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELIAZAR
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-287-0333
Mailing Address - Street 1:1215 S EXPRESSWAY 281
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-7220
Mailing Address - Country:US
Mailing Address - Phone:956-287-0333
Mailing Address - Fax:956-287-1986
Practice Address - Street 1:1215 S EXPRESSWAY 281
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78542-7220
Practice Address - Country:US
Practice Address - Phone:956-287-0333
Practice Address - Fax:956-287-1986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty