Minnie D. Cruz

Key facts

NPI

1871509604

Entity type

Organization (NPI type 2)

Primary specialty

Assisted Living Facility (Behavioral Disturbances) 3104A0630X

License

117528 (TX)

Legal business name

MINNIE D. CRUZ

Practice address

730 County Road 664
Devine, TX 78016-4685

Phone

(830) 665-4801

Fax

(830) 665-4801

NPI assigned

Aug 1, 2006

Organization subpart

No

Authorized official

Name

Ms. Minnie Duncan Cruz

Title

Owner

Phone

(830) 665-4801

National Provider Directory

Specialties & licenses

Addresses

Other identifiers

Other names

• Cruz Personal Care Home Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 21, 2020.

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590019200000",
    "number": "1871509604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 COUNTY ROAD 664",
            "city": "DEVINE",
            "state": "TX",
            "postal_code": "780164685",
            "telephone_number": "830-665-4801",
            "fax_number": "830-665-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 COUNTY ROAD 664",
            "city": "DEVINE",
            "state": "TX",
            "postal_code": "780164685",
            "telephone_number": "830-665-4801",
            "fax_number": "830-665-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNIE D. CRUZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2020-05-21",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "MINNIE",
        "authorized_official_middle_name": "DUNCAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "830-665-4801",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "TX",
            "license": "117528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL SECURITY #",
            "identifier": "$$$$$$$$$",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cruz Personal Care Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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