Provider Demographics
NPI:1285122242
Name:AMIGOS PARA SIEMPRE PROVIDER SERVICE LLC
Entity type:Organization
Organization Name:AMIGOS PARA SIEMPRE PROVIDER SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-789-7280
Mailing Address - Street 1:305 ELIDA ST
Mailing Address - Street 2:
Mailing Address - City:PALMHURST
Mailing Address - State:TX
Mailing Address - Zip Code:78573-3614
Mailing Address - Country:US
Mailing Address - Phone:956-789-7280
Mailing Address - Fax:956-583-3993
Practice Address - Street 1:305 ELIDA ST
Practice Address - Street 2:
Practice Address - City:PALMHURST
Practice Address - State:TX
Practice Address - Zip Code:78573-3614
Practice Address - Country:US
Practice Address - Phone:956-789-7280
Practice Address - Fax:956-583-3993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-25
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health