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Organization
MANANTIAL
Active
Organization
MANANTIAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL HUMBERTO GUAJARDO (PRESIDENT)
(956) 542-7680
Entity
Organization
Contact information
Practice address
6097 RABBIT RUN DR, BROWNSVILLE, TX 78526-4129
(956) 542-7680
Mailing address
6097 RABBIT RUN DR, BROWNSVILLE, TX 78526-4129
(956) 542-7680
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
Other
Enumeration date
02/04/2009
Last updated
02/04/2009
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