Provider Demographics
NPI:1043502610
Name:MI FAMILIA PRIMARY HOME CARE LLC
Entity type:Organization
Organization Name:MI FAMILIA PRIMARY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARAGOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-905-5704
Mailing Address - Street 1:1403 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-5023
Mailing Address - Country:US
Mailing Address - Phone:817-905-5704
Mailing Address - Fax:817-412-9710
Practice Address - Street 1:1403 JAMES ST
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-5023
Practice Address - Country:US
Practice Address - Phone:817-905-5704
Practice Address - Fax:817-412-9710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health