Healthcare Provider Details

I. General information

NPI: 1689370108
Provider Name (Legal Business Name): LA TRINIDAD ADULT DAY CARE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 04/08/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1304 W VETERANS BLVD
PALMVIEW TX
78572-8115
US

IV. Provider business mailing address

1304 W VETERANS BLVD
PALMVIEW TX
78572-8115
US

V. Phone/Fax

Practice location:
  • Phone: 956-600-8055
  • Fax: 956-600-7366
Mailing address:
  • Phone: 956-600-8055
  • 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: GUILLERMO OLIVARES
Title or Position: OWNER
Credential:
Phone: 956-600-8055