Organization
LA VIDA DIVINA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRISCILLA TORRE (ADMINISTRATOR)
(512) 696-7417
Entity
Organization
Contact information
Practice address
302 E QUEEN ISABELLA BLVD STE C, PORT ISABEL, TX 78578-2407
(512) 696-7417
(956) 396-0555
Mailing address
302 E QUEEN ISABELLA BLVD STE C, PORT ISABEL, TX 78578-2407
(512) 696-7417
(956) 396-0555
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
10/22/2019
Last updated
10/15/2024
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