Provider Demographics
NPI:1831327014
Name:MIRAGE HEALTHCARE SERVICES INC
Entity type:Organization
Organization Name:MIRAGE HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EVARISTUS
Authorized Official - Middle Name:I
Authorized Official - Last Name:AJAERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-867-7970
Mailing Address - Street 1:2825 WILCREST DR STE 518
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-6041
Mailing Address - Country:US
Mailing Address - Phone:713-867-7970
Mailing Address - Fax:713-867-7970
Practice Address - Street 1:2825 WILCREST DR STE 518
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-6041
Practice Address - Country:US
Practice Address - Phone:713-867-7970
Practice Address - Fax:713-867-7970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-26
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health