Healthcare Provider Details

I. General information

NPI: 1396136537
Provider Name (Legal Business Name): NEW AGE ADULT DAY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2015
Last Update Date: 02/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E INTERSTATE 2 SUITE E
PHARR TX
78577-6562
US

IV. Provider business mailing address

PO BOX 1768
PHARR TX
78577-1633
US

V. Phone/Fax

Practice location:
  • Phone: 956-212-8408
  • Fax:
Mailing address:
  • Phone: 956-212-8408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number137993
License Number StateTX

VIII. Authorized Official

Name: MS. MARIA SANIN
Title or Position: PRESIDENT
Credential:
Phone: 956-212-8408