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Organization

VAL-ROD DBA CLUB DE AMISTAD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMADOR RODRIGUEZ (ADMINISTRATOR)
(915) 859-8671
Entity
Organization

Contact information

Practice address
109 CROCKER DR, HORIZON CITY, TX 79928-7153
(915) 852-5006
(915) 852-2792
Mailing address
681 HORIZON BLVD STE G, SOCORRO, TX 79927-4692
(915) 860-8690
(915) 859-3985

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
102237
TX
261QA0600X
Adult Day Care Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
146065672
TX
Enumeration date
12/08/2006
Last updated
06/25/2019
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