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Individual

ALFREDO MIGUEL CANCINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4806 LAS PALOMAS ST, BROWNSVILLE, TX 78526-3847
(956) 546-7303
Mailing address
4806 LAS PALOMAS ST, BROWNSVILLE, TX 78526-3847

Taxonomy

Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
TX
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
TX

Other

Enumeration date
06/23/2008
Last updated
06/23/2008
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