Provider Demographics
NPI:1255542791
Name:AMIGO HEALTH SERVICES, CORP.
Entity type:Organization
Organization Name:AMIGO HEALTH SERVICES, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-343-7341
Mailing Address - Street 1:1225 N EXPRESSWAY STE 3A
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-8355
Mailing Address - Country:US
Mailing Address - Phone:956-343-7341
Mailing Address - Fax:956-544-7099
Practice Address - Street 1:1225 N EXPRESSWAY STE 3A
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8355
Practice Address - Country:US
Practice Address - Phone:956-343-7341
Practice Address - Fax:956-544-7099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010645251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health