Organization
GUSTAVOS BLUE SHARK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GILDA GIL (BOARD PRESIDENT)
(915) 726-0787
Entity
Organization
Contact information
Practice address
7000 DIAMOND RIDGE DR, EL PASO, TX 79912-7696
(915) 726-0787
(915) 496-0751
Mailing address
7000 DIAMOND RIDGE DR, EL PASO, TX 79912-7696
(915) 726-0787
(915) 496-0751
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
01/18/2012
Last updated
03/09/2012
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