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Organization
MAVERICK ADULT DAY CARE L.L.C.
Active
Organization
MAVERICK ADULT DAY CARE L.L.C.
Active
Other names
Fort Duncan Home Health and Hospice Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAPHAEL SANTANA R.N., BNS (ADMIN)
(830) 757-0966
Entity
Organization
Contact information
Practice address
3147 MEGAN ST, EAGLE PASS, TX 78852-5891
(830) 757-0966
(830) 757-0976
Mailing address
3147 MEGAN ST, EAGLE PASS, TX 78852-5891
(830) 757-0966
(830) 757-0976
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
009852
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192509103
—
TX
05
—
192509104
—
TX
Enumeration date
06/23/2009
Last updated
06/23/2009
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