Organization
RAICES PROVIDER SERVICES, LLC
Active
Other names
Raices Provider Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CORINA SALAZAR (OWNER)
(956) 402-1603
Entity
Organization
Contact information
Practice address
120 AMY DR, SAN JUAN, TX 78589-3700
(956) 402-1603
Mailing address
PO BOX 949, SAN JUAN, TX 78589-0949
(956) 402-1603
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
02/08/2020
Last updated
02/08/2020
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