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Organization
TO THE MOON AND BACK PERSONAL CARE LLC
Active
Organization
TO THE MOON AND BACK PERSONAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE DAINE RODRIGUEZ (OWNER)
(915) 667-7320
Entity
Organization
Contact information
Practice address
7318 GILLETT ST, CANUTILLO, TX 79835-6421
(915) 667-7320
Mailing address
PO BOX 793, CANUTILLO, TX 79835-0793
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
Other
Enumeration date
05/23/2017
Last updated
05/23/2017
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