Organization
VIDA NUEVA ADULT DAY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ESPERANZA RUIZ (FACILITY MANAGER)
(830) 694-2445
Entity
Organization
Contact information
Practice address
409 W ZAVALA ST, CRYSTAL CITY, TX 78839-3241
(830) 854-2001
(830) 854-2150
Mailing address
409 W ZAVALA ST, CRYSTAL CITY, TX 78839-3241
(830) 854-2001
(830) 854-2150
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
139178
TX
302F00000X
Exclusive Provider Organization
Primary
—
TX
Other
Enumeration date
10/29/2013
Last updated
01/28/2021
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