Organization
AMISTAD PROVIDER AGENCY, INC.
Active
Other names
Amistad Provider Agency, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MYRNA I CANTU (ADMINISTRATOR)
(956) 867-8881
Entity
Organization
Contact information
Practice address
601 E MCINTYRE AVE, EDINBURG, TX 78541
(956) 318-3235
(956) 318-3240
Mailing address
601 E MCINTYRE AVE, EDINBURG, TX 78541
(956) 318-3235
(956) 318-3240
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
012246
TX
3747P1801X
Personal Care Attendant
Primary
012246
TX
385H00000X
Respite Care
012246
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1854903-01
—
TX
Enumeration date
08/23/2007
Last updated
06/11/2024
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