Organization
MI RANCHITO PHC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA MONTEMAYOR (OWNER)
(956) 519-8886
Entity
Organization
Contact information
Practice address
824 E EXPRESSWAY 83, LA JOYA, TX 78560-4178
(956) 519-8886
(956) 519-8887
Mailing address
PO BOX 2003, LA JOYA, TX 78560-2003
(956) 519-8888
(956) 519-8887
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
09/12/2017
Last updated
09/12/2017
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