Organization
MISSION ADULT & SENIOR CARE CENTER PA.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA L RUGAMA (SUPERVISOR)
(956) 581-2770
Entity
Organization
Contact information
Practice address
2121 E GRIFFIN PKWY STE 4, MISSION, TX 78574-3072
(956) 581-2770
(956) 581-7811
Mailing address
PO BOX 1059, MISSION, TX 78573-0017
(956) 581-2770
(956) 581-7811
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J4669
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155641701
—
TX
Enumeration date
04/11/2007
Last updated
03/18/2011
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