Provider Demographics
NPI:1053784876
Name:MOLINA, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MOLINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAURAS FOSTER HOME
Other - Middle Name:
Other - Last Name:LAURAS FOSTER HOME
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAURAS FOSTER HOME
Mailing Address - Street 1:7613 ALPINE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79915-1527
Mailing Address - Country:US
Mailing Address - Phone:915-626-6722
Mailing Address - Fax:
Practice Address - Street 1:7613 ALPINE DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-1527
Practice Address - Country:US
Practice Address - Phone:915-626-6722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-02
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No172V00000XOther Service ProvidersCommunity Health Worker