Provider Demographics
NPI:1184868358
Name:MONTECITO ALLIED HEALTH, LLC
Entity type:Organization
Organization Name:MONTECITO ALLIED HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANICETO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:713-277-8771
Mailing Address - Street 1:PO BOX 20433
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77225-0433
Mailing Address - Country:US
Mailing Address - Phone:713-277-8771
Mailing Address - Fax:
Practice Address - Street 1:2213 S BRAESWOOD BLVD # 31A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4321
Practice Address - Country:US
Practice Address - Phone:713-277-8771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-01
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty