Healthcare Provider Details

I. General information

NPI: 1841536638
Provider Name (Legal Business Name): BLANQUITA'S ADULT DAY CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2012
Last Update Date: 10/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1537 S VETERANS BLVD
EAGLE PASS TX
78852-6474
US

IV. Provider business mailing address

1537 S VETERANS BLVD
EAGLE PASS TX
78852-6474
US

V. Phone/Fax

Practice location:
  • Phone: 830-352-4013
  • Fax: 830-752-6299
Mailing address:
  • Phone: 830-352-4013
  • Fax: 830-752-6299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. YOLANDA P. RAMON
Title or Position: OWNER/ALT. ADMINISTRATOR
Credential: MASTERS IN EDUCATION
Phone: 830-352-4013