Provider Demographics
NPI:1891737607
Name:ONE LAC, INC.
Entity Type:Organization
Organization Name:ONE LAC, INC.
Other - Org Name:ALPHA CARE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:MORA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-631-1022
Mailing Address - Street 1:701 EAST ESPERANZA
Mailing Address - Street 2:SUITE A
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501
Mailing Address - Country:US
Mailing Address - Phone:956-631-1022
Mailing Address - Fax:956-631-1224
Practice Address - Street 1:701 EAST ESPERANZA
Practice Address - Street 2:SUITE A
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501
Practice Address - Country:US
Practice Address - Phone:956-631-1022
Practice Address - Fax:956-631-1224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012991251E00000X
TX74-7144251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX012991OtherSTATE LICENSE
TX2063530201Medicaid
TX747144Medicare PIN