Healthcare Provider Details

I. General information

NPI: 1780924985
Provider Name (Legal Business Name): SOL Y LUNA ADULT DAYCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2013
Last Update Date: 07/21/2022
Certification Date: 05/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 GEORGE DIETER DR
EL PASO TX
79936-2946
US

IV. Provider business mailing address

2911 GEORGE DIETER DR
EL PASO TX
79936-2946
US

V. Phone/Fax

Practice location:
  • Phone: 915-590-5862
  • Fax:
Mailing address:
  • Phone: 915-590-5862
  • 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: ELIZABETH BURKETT
Title or Position: OWNER
Credential:
Phone: 915-850-4896