Provider Demographics
NPI:1801317920
Name:PEOPLE WITH IDEAS OF LOVE, LIBERTY, ACCEPTANCE AND RESPECT PILLAR
Entity type:Organization
Organization Name:PEOPLE WITH IDEAS OF LOVE, LIBERTY, ACCEPTANCE AND RESPECT PILLAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTURO
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-723-7457
Mailing Address - Street 1:6406 MCPHERSON RD STE 2
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6258
Mailing Address - Country:US
Mailing Address - Phone:956-723-7457
Mailing Address - Fax:956-704-5155
Practice Address - Street 1:6406 MCPHERSON RD STE 2
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6258
Practice Address - Country:US
Practice Address - Phone:956-723-7457
Practice Address - Fax:956-704-5155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-28
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X
TX39843985101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty