| Organization Name: | MIRADO, LLC |
| NPI Number: | 1588967863 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ADOLFO REYES (GOVERNING PERSON) |
| Mailing Address: | 119 W Rice St Falfurrias |
| State: | TX US |
| Postal Code: | 783553701 |
| Phone Number: | 3613253600 |
| Fax Number: | 3613254410 |
| NPI Enumeration Date: | 12/08/2010 |
| NPI Last Update Date: | 12/08/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA0600X |
| License Number: | 130262 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Day Care |
| Taxonomy Definition: | |