Healthcare Provider Details

I. General information

NPI: 1609189182
Provider Name (Legal Business Name): NUEVO DIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2010
Last Update Date: 07/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 THUNDERBIRD DR SUITE J
EL PASO TX
79912-4541
US

IV. Provider business mailing address

125 THUNDERBIRD DR SUITE J
EL PASO TX
79912-4541
US

V. Phone/Fax

Practice location:
  • Phone: 915-422-8399
  • Fax: 915-581-7599
Mailing address:
  • Phone: 915-422-8399
  • Fax: 915-581-7599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SOCORRO MAYNEZ-OLMOS
Title or Position: L.P.C.
Credential: SOLE PROPRIETOR
Phone: 915-422-8399