Provider Demographics
NPI:1952635153
Name:NINOS 1ST
Entity Type:Organization
Organization Name:NINOS 1ST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:NOE
Authorized Official - Last Name:OLIVARZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-893-3144
Mailing Address - Street 1:25224 N KANSAS CITY RD
Mailing Address - Street 2:
Mailing Address - City:LA FERIA
Mailing Address - State:TX
Mailing Address - Zip Code:78559
Mailing Address - Country:US
Mailing Address - Phone:956-893-3144
Mailing Address - Fax:
Practice Address - Street 1:25224 N KANSAS CITY RD
Practice Address - Street 2:
Practice Address - City:LA FERIA
Practice Address - State:TX
Practice Address - Zip Code:78559-4513
Practice Address - Country:US
Practice Address - Phone:956-893-3144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QUALITY COMMUNITY SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-22
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management