Provider Demographics
NPI:1063580827
Name:RURAL ECONOMIC ASSISTANCE LEAGUE, INC.
Entity type:Organization
Organization Name:RURAL ECONOMIC ASSISTANCE LEAGUE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:361-668-3158
Mailing Address - Street 1:301 LUCERO ST
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332-5848
Mailing Address - Country:US
Mailing Address - Phone:361-668-3158
Mailing Address - Fax:361-664-9695
Practice Address - Street 1:301 LUCERO ST
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-5848
Practice Address - Country:US
Practice Address - Phone:361-668-3158
Practice Address - Fax:361-664-9695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001433251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001002393OtherMDCP
TX0236739-01Medicaid
TX0122319-01Medicaid