| NPI | 1013549922 |
|---|---|
| Former Legal Business Name | RAICES PROVIDER SERVICES, LLC |
| Entity Type | Organization |
| Authorized Contact | CORINA SALAZAR Owner 956-402-1603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Enumeration Date | 2020-02-08 |
| Last Update Date | 2020-02-08 |