Healthcare Provider Details

I. General information

NPI: 1083930010
Provider Name (Legal Business Name): ABEJA REYNA ADULT DAY CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2010
Last Update Date: 04/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 E. ELIDA ST
PALMHURST TX
78572
US

IV. Provider business mailing address

1403 SAPPHIRE ST
PENITAS TX
78576-8112
US

V. Phone/Fax

Practice location:
  • Phone: 956-584-1901
  • Fax: 956-584-1902
Mailing address:
  • Phone: 956-584-1901
  • Fax: 956-584-1902

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: MELISSA GARCIA
Title or Position: CEO
Credential:
Phone: 956-309-3433