Organization
EL#1ADULTDAYCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENE R. VELA (OFFICE MANAGER)
(956) 636-1018
Entity
Organization
Contact information
Practice address
11861 WEST HWY 107, SANTA ROSA, TX 78593
(956) 636-1018
(956) 636-1720
Mailing address
11861 WEST HWY 107, P.O.BOX323, SANTA ROSA, TX 78593
(956) 636-1018
(956) 636-1720
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
115809
TX
Other
Enumeration date
03/01/2007
Last updated
08/22/2020
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