Healthcare Provider Details

I. General information

NPI: 1740681634
Provider Name (Legal Business Name): ROKA ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2014
Last Update Date: 09/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12025 ROJAS DR STE JANDK
EL PASO TX
79936-7759
US

IV. Provider business mailing address

12025 ROJAS DR STE JANDK
EL PASO TX
79936-7759
US

V. Phone/Fax

Practice location:
  • Phone: 915-849-1505
  • Fax:
Mailing address:
  • Phone: 915-849-1505
  • Fax:

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: MANUEL OSCAR ROCHA
Title or Position: C.F.O
Credential: MASTERS
Phone: 303-919-9994