Organization
MEDELLA HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIKA TAVAREZ CMF (OWNER)
(915) 540-5195
Entity
Organization
Contact information
Practice address
702 E YANDELL DR, EL PASO, TX 79902-5314
(915) 955-2525
(915) 201-1318
Mailing address
702 E YANDELL DR, EL PASO, TX 79902-5314
(915) 955-2525
(915) 201-1318
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
—
—
246RM2200X
Medical Laboratory Technician
—
—
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32072474136
COMPTROLLER
TX
Enumeration date
11/16/2019
Last updated
01/10/2023
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