Provider Demographics
NPI:1679944243
Name:MED-CARE P.A. LLC
Entity type:Organization
Organization Name:MED-CARE P.A. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLAGRANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-867-0026
Mailing Address - Street 1:101 PALOMAS CT
Mailing Address - Street 2:
Mailing Address - City:SUNLAND PARK
Mailing Address - State:NM
Mailing Address - Zip Code:88063-9225
Mailing Address - Country:US
Mailing Address - Phone:575-589-0811
Mailing Address - Fax:575-589-4818
Practice Address - Street 1:101 PALOMAS CT
Practice Address - Street 2:
Practice Address - City:SUNLAND PARK
Practice Address - State:NM
Practice Address - Zip Code:88063-9225
Practice Address - Country:US
Practice Address - Phone:575-589-0811
Practice Address - Fax:575-589-4818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM03258753008253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care