Healthcare Provider Details

I. General information

NPI: 1518631829
Provider Name (Legal Business Name): GRIMALDO'S ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2021
Last Update Date: 02/01/2023
Certification Date: 02/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 W BUSINESS 83
DONNA TX
78537-9494
US

IV. Provider business mailing address

503 W BUSINESS 83
DONNA TX
78537-9494
US

V. Phone/Fax

Practice location:
  • Phone: 956-461-1093
  • Fax: 956-461-1094
Mailing address:
  • Phone: 956-461-1093
  • Fax: 956-461-1094

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: GEORGE GRIMALDO
Title or Position: OWNER
Credential:
Phone: 956-207-5357