Provider Demographics
NPI:1477763605
Name:MILAGROS II HOME CARE, INC
Entity Type:Organization
Organization Name:MILAGROS II HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR DON
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CUELLAR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-969-8076
Mailing Address - Street 1:1008 N BORDER AVE
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-4322
Mailing Address - Country:US
Mailing Address - Phone:956-969-8076
Mailing Address - Fax:956-973-0302
Practice Address - Street 1:1008 N BORDER AVE
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-4322
Practice Address - Country:US
Practice Address - Phone:956-969-8076
Practice Address - Fax:956-973-0302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX453167251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX453167Medicare Oscar/Certification