Organization
MI ILUSION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CARMEN E RODRIGUEZ (ADMINISTRATOR)
(956) 457-1998
Entity
Organization
Contact information
Practice address
3421 W PALMA VISTA DR, PALMVIEW, TX 78572-1863
(956) 424-6067
(956) 424-6166
Mailing address
3421 W PALMA VISTA DR, PALMVIEW, TX 78572-1863
(956) 424-6067
(956) 424-6166
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
TX
Other
Enumeration date
12/11/2010
Last updated
07/29/2019
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