Organization
M'AGINE SUPPORTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODOLFO MORENO (ADMINISTRATOR)
(361) 851-0311
Entity
Organization
Contact information
Practice address
4626 WEBER RD STE 21, CORPUS CHRISTI, TX 78411-3542
(361) 851-0311
Mailing address
4626 WEBER RD STE 21, CORPUS CHRISTI, TX 78411-3542
(361) 851-0311
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
04/07/2015
Last updated
04/07/2015
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