Provider Demographics
NPI:1659568459
Name:MI FAMILIA ADC AND HEALTH SERVICES,LLC
Entity Type:Organization
Organization Name:MI FAMILIA ADC AND HEALTH SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-876-9021
Mailing Address - Street 1:203 W HOUSTON ST
Mailing Address - Street 2:
Mailing Address - City:CARRIZO SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78834-3200
Mailing Address - Country:US
Mailing Address - Phone:830-876-9021
Mailing Address - Fax:830-876-9041
Practice Address - Street 1:203 W HOUSTON ST
Practice Address - Street 2:
Practice Address - City:CARRIZO SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78834-3200
Practice Address - Country:US
Practice Address - Phone:830-876-9021
Practice Address - Fax:830-876-9041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX148674313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility