Provider Demographics
NPI:1366215485
Name:MESQUITE HOSPICE CARE LLC
Entity type:Organization
Organization Name:MESQUITE HOSPICE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DON/ALT. ADM
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:RUVALCABA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-361-5558
Mailing Address - Street 1:594 JOSE MARTI BLVD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-1787
Mailing Address - Country:US
Mailing Address - Phone:956-361-5558
Mailing Address - Fax:956-361-5559
Practice Address - Street 1:594 JOSE MARTI BLVD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-1787
Practice Address - Country:US
Practice Address - Phone:956-361-5558
Practice Address - Fax:956-361-5559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based