Healthcare Provider Details

I. General information

NPI: 1851504252
Provider Name (Legal Business Name): LA LUZ ADULT DAY CARE L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 06/30/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2349 E SAUNDERS
LAREDO TX
78040
US

IV. Provider business mailing address

2349 E SAUNDERS ST
LAREDO TX
78041-5434
US

V. Phone/Fax

Practice location:
  • Phone: 956-724-7859
  • Fax: 956-724-5801
Mailing address:
  • Phone: 956-722-3225
  • Fax: 956-724-5801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: NORA D HERNANDEZ
Title or Position: ADMINISTRATOR/RN
Credential: RN
Phone: 956-724-7859