Seventeen Lac Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

011500 Issued in TX

Legal business name

SEVENTEEN LAC INC.

Doing business as

Care Stat;'s Buena Aventura

Practice address

2412 Jacaman Rd
Suite 104
Laredo, TX 78041-6229

Phone

(956) 727-1900

Fax

(956) 727-1718

NPI assigned

Sep 20, 2006

Last updated

Dec 12, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Veronica Cantu

Title

Ceo/President

Phone

(956) 727-1900

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Care Stat;'s Buena Aventura Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355270400000",
    "number": "1396842761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 450249",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780450249",
            "telephone_number": "956-727-1900",
            "fax_number": "956-727-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 JACAMAN RD",
            "address_2": "SUITE 104",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780416229",
            "telephone_number": "956-727-1900",
            "fax_number": "956-727-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEVENTEEN LAC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-12-12",
        "status": "A",
        "authorized_official_last_name": "CANTU",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "956-727-1900",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "011500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CERTIFICATION OR PTAN",
            "identifier": "74-7295",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Care Stat;'s Buena Aventura",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Laredo, TX
• Providers in Laredo, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.