Provider Demographics
NPI:1922407410
Name:LULAC PROJECT AMISTAD
Entity Type:Organization
Organization Name:LULAC PROJECT AMISTAD
Other - Org Name:PROJECT AMISTAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-875-2887
Mailing Address - Street 1:3210 DYER ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79930-6230
Mailing Address - Country:US
Mailing Address - Phone:915-875-2887
Mailing Address - Fax:915-532-7463
Practice Address - Street 1:3210 DYER ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79930-6230
Practice Address - Country:US
Practice Address - Phone:915-875-2887
Practice Address - Fax:915-532-7463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-20
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)