Healthcare Provider Details

I. General information

NPI: 1639238330
Provider Name (Legal Business Name): NUEVO AMANECER ADULT DAY CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 07/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5224 N CAGE STE 1
PHARR TX
78577
US

IV. Provider business mailing address

5224 N CAGE STE 1
PHARR TX
78577
US

V. Phone/Fax

Practice location:
  • Phone: 956-782-8844
  • Fax:
Mailing address:
  • Phone: 956-782-8844
  • Fax: 956-782-8847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number119144
License Number StateTX

VIII. Authorized Official

Name: ROSABEL GONZALEZ
Title or Position: PRESIDENT OWNER
Credential:
Phone: 956-782-8844