Provider Demographics
NPI:1356384416
Name:MIA MARIPOSA HOME HEALTH CARE
Entity type:Organization
Organization Name:MIA MARIPOSA HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SENAIDA
Authorized Official - Middle Name:B
Authorized Official - Last Name:CHAVANA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-878-9134
Mailing Address - Street 1:2809 VINE STREET
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501
Mailing Address - Country:US
Mailing Address - Phone:956-878-9134
Mailing Address - Fax:956-928-0358
Practice Address - Street 1:2809 VINE STREET
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501
Practice Address - Country:US
Practice Address - Phone:956-878-9134
Practice Address - Fax:956-928-0358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010421251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health