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Organization

VIDA ADULT DAY CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAY VALDEZ (PROGRAM DIRECTOR)
(830) 374-7685
Entity
Organization

Contact information

Practice address
815 N 7TH AVE, CRYSTAL CITY, TX 78839-2611
(830) 374-7685
(830) 374-9996
Mailing address
815 NORTH 7TH, CRYSTAL CITY, TX 78839
(830) 374-7685
(830) 374-9996

Taxonomy

Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
TX

Other

Enumeration date
06/23/2011
Last updated
06/23/2011
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