Provider Demographics
NPI:1770708265
Name:MIZPAH RESIDENTIAL CARE. INC.
Entity type:Organization
Organization Name:MIZPAH RESIDENTIAL CARE. INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHUTEI
Authorized Official - Middle Name:
Authorized Official - Last Name:VARKEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-365-3646
Mailing Address - Street 1:902 E GRIMES ST
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8881
Mailing Address - Country:US
Mailing Address - Phone:956-365-3646
Mailing Address - Fax:956-365-3651
Practice Address - Street 1:902 E GRIMES ST
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8881
Practice Address - Country:US
Practice Address - Phone:956-365-3646
Practice Address - Fax:956-365-3651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008379251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health