Provider Demographics
NPI:1124304225
Name:MIL ENTERPRISES INC.
Entity type:Organization
Organization Name:MIL ENTERPRISES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NARES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:915-328-0447
Mailing Address - Street 1:1417 DELTA DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79901-3119
Mailing Address - Country:US
Mailing Address - Phone:915-328-0447
Mailing Address - Fax:915-585-4565
Practice Address - Street 1:1417 DELTA DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79901-3119
Practice Address - Country:US
Practice Address - Phone:915-328-0447
Practice Address - Fax:915-585-4565
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIL ENTERPRISES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-02
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149722Medicaid