Healthcare Provider Details

I. General information

NPI: 1205004496
Provider Name (Legal Business Name): WILLOW SERVICES INC. DBA LAS FLORES ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 07/21/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2502 E TRAVIS
LAREDO TX
78046
US

IV. Provider business mailing address

2502 E. TRAVIS
LAREDO TX
78043
US

V. Phone/Fax

Practice location:
  • Phone: 956-718-2810
  • Fax: 956-718-2811
Mailing address:
  • Phone: 956-718-2810
  • Fax: 956-718-2811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number121932
License Number StateTX

VIII. Authorized Official

Name: ZULEMA GARZA
Title or Position: OWNER
Credential:
Phone: 956-718-2810