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Organization

LA GRAN VIDA ADULT DAYCARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEAN R JOSEPH-VANDERPOOL MD (ASSOCIATE CEO)
(915) 241-2012
Entity
Organization

Contact information

Practice address
8825 N LOOP DR STE 114, EL PASO, TX 79907-4606
(915) 329-4161
Mailing address
8825 N LOOP DR STE 114, EL PASO, TX 79907-4606

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
TX

Other

Enumeration date
03/02/2010
Last updated
03/02/2010
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