Provider Demographics
NPI:1912019068
Name:EN MI CASA PRIMARY HOME CARE, INC.
Entity Type:Organization
Organization Name:EN MI CASA PRIMARY HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EFRAIN
Authorized Official - Middle Name:EDUARDO
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-239-2143
Mailing Address - Street 1:2778 N FM 755
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-9790
Mailing Address - Country:US
Mailing Address - Phone:956-487-2951
Mailing Address - Fax:956-487-2951
Practice Address - Street 1:2778 N FM 755
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-9790
Practice Address - Country:US
Practice Address - Phone:956-487-2951
Practice Address - Fax:956-487-2951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010662251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health