| Organization Name: | AMIGOS CRISTIANOS LLC |
| NPI Number: | 1225382518 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CONNIE S. FODRIE (CEO/OWNER) |
| Mailing Address: | 1700 6th Street Bay City |
| State: | TX US |
| Postal Code: | 774145021 |
| Phone Number: | 9793237099 |
| Fax Number: | 9793230555 |
| NPI Enumeration Date: | 11/08/2012 |
| NPI Last Update Date: | 07/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 015661 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |