Provider Demographics
NPI:1659655397
Name:MISSION PERSONAL ASSISTANCE SERVICE, INC.
Entity type:Organization
Organization Name:MISSION PERSONAL ASSISTANCE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:HOMERO
Authorized Official - Last Name:GUAJARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-282-9613
Mailing Address - Street 1:7705 PAWNEE CT
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1116
Mailing Address - Country:US
Mailing Address - Phone:915-282-9613
Mailing Address - Fax:915-832-0431
Practice Address - Street 1:7705 PAWNEE CT
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1116
Practice Address - Country:US
Practice Address - Phone:915-282-9613
Practice Address - Fax:915-832-0431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health