CMS-1500 Box 24J / 33a • NPI
1871509604
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
3104A0630X
Licensed & Credentialed Assisted Living Facility, Assisted Living, Behavioral Disturbances
Box 32 Service Location & ZIP+4
730 COUNTY ROAD 664, DEVINE, TX, 78016-4685
✓ 9-Digit EDI 837 ZIP+4 (78016-4685)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1871509604 (MINNIE D. CRUZ) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1871509604 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | MINNIE D. CRUZ |
| Plain-English Specialty | Licensed & Credentialed Assisted Living Facility, Assisted Living, Behavioral Disturbances NUCC Code: 3104A0630X (Assisted Living Facility, Assisted Living, Behavioral Disturbances) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 730 COUNTY ROAD 664, DEVINE, TX, 78016-4685 |
| Practice Telephone / Fax | Tel: (830) 665-4801 | Fax: (830) 665-4801 |
| Administrative Mailing Address | 730 COUNTY ROAD 664, DEVINE, TX, 78016-4685 |
| Enumeration & Last Sync | Enumerated: 2006-08-01 | CMS Record Updated: 2020-05-21 |
| Authorized Official | MINNIE CRUZ (Owner) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (3104A0630X)
What Does Taxonomy Code 3104A0630X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 3104A0630X translates to:
"Licensed & Credentialed Assisted Living Facility, Assisted Living, Behavioral Disturbances"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (MINNIE D. CRUZ)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
3104A0630X — Assisted Living Facility, Assisted Living, Behavioral DisturbancesPlain English: Licensed & Credentialed Assisted Living Facility, Assisted Living, Behavioral Disturbances | State: TX | License: 117528 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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