Healthcare Provider Details

I. General information

NPI: 1376707166
Provider Name (Legal Business Name): PREFERRED ADULT DAY CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2008
Last Update Date: 07/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8825 NORTH LOOP SUITES 118-119
EL PASO TX
79907
US

IV. Provider business mailing address

2104 BEACH FRONT DR
EL PASO TX
79936-3917
US

V. Phone/Fax

Practice location:
  • Phone: 915-857-5029
  • Fax:
Mailing address:
  • Phone: 915-857-5029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARY CRUZ FERREL
Title or Position: OWNER
Credential:
Phone: 915-857-5029