Healthcare Provider Details

I. General information

NPI: 1962849273
Provider Name (Legal Business Name): LA VIDA BUENA DAYCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2013
Last Update Date: 06/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 E 6TH ST
ALICE TX
78332-4656
US

IV. Provider business mailing address

1004 E 6TH ST
ALICE TX
78332-4656
US

V. Phone/Fax

Practice location:
  • Phone: 361-668-0850
  • Fax: 361-668-0869
Mailing address:
  • Phone: 361-668-0850
  • Fax: 361-668-0869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LOUISE WOODS
Title or Position: ADMINISTRATIVE ASSISTANT
Credential:
Phone: 361-668-0850