Healthcare Provider Details

I. General information

NPI: 1992203087
Provider Name (Legal Business Name): VILLAGE CENTER ADULT DAYCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2018
Last Update Date: 01/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6419 MCPHERSON RD STE H
LAREDO TX
78041-6215
US

IV. Provider business mailing address

6419 MCPHERSON RD STE H
LAREDO TX
78041-6215
US

V. Phone/Fax

Practice location:
  • Phone: 956-724-4521
  • Fax: 956-727-0986
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JUAN RAMIREZ
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 956-724-4521