Healthcare Provider Details

I. General information

NPI: 1114290673
Provider Name (Legal Business Name): ESMERALDA'S ADULT DAY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2012
Last Update Date: 03/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 LAFAYETTE ST
LAREDO TX
78041-4706
US

IV. Provider business mailing address

1320 LAFAYETTE ST
LAREDO TX
78041-4706
US

V. Phone/Fax

Practice location:
  • Phone: 956-728-7598
  • Fax: 956-728-7589
Mailing address:
  • Phone: 956-728-7598
  • 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: MRS. MARIA ESMERALDA ALVARADO
Title or Position: DIRECTOR
Credential:
Phone: 956-728-7598