Organization
CORAZONES JOVENES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILIA QUINTANA (MANAGER)
(915) 408-1042
Entity
Organization
Contact information
Practice address
13912 DADE RD, EL PASO, TX 79938-8277
(915) 921-8802
Mailing address
13912 DADE RD, EL PASO, TX 79938-8277
(915) 921-8802
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32067096001
ADULT DAY CARE FACILITY
TX
Enumeration date
06/04/2018
Last updated
06/04/2018
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