Provider Demographics
NPI:1770800468
Name:MI TIERRA ADULT DAY CARE, LLC
Entity type:Organization
Organization Name:MI TIERRA ADULT DAY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANSISCO
Authorized Official - Middle Name:
Authorized Official - Last Name:RANGEL
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:956-400-5174
Mailing Address - Street 1:2406 BROCK ST STE 7
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-3375
Mailing Address - Country:US
Mailing Address - Phone:956-776-6364
Mailing Address - Fax:
Practice Address - Street 1:2406 BROCK ST STE 7
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3375
Practice Address - Country:US
Practice Address - Phone:956-776-6364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care