Provider Demographics
NPI:1265806103
Name:NENA'S PROVIDER SERVICES, LLC
Entity type:Organization
Organization Name:NENA'S PROVIDER SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMEBER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ELENA
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-330-5575
Mailing Address - Street 1:1524 DOHERTY AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-4019
Mailing Address - Country:US
Mailing Address - Phone:956-330-5575
Mailing Address - Fax:956-583-4621
Practice Address - Street 1:1524 DOHERTY AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-4019
Practice Address - Country:US
Practice Address - Phone:956-330-5575
Practice Address - Fax:956-583-4621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health