Healthcare Provider Details

I. General information

NPI: 1114227956
Provider Name (Legal Business Name): PARAISO DEL RIO ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2010
Last Update Date: 10/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2915 ALPHA ST SUITE B
RIO GRANDE CITY TX
78582-6785
US

IV. Provider business mailing address

2915 ALPHA ST SUITE B
RIO GRANDE CITY TX
78582
US

V. Phone/Fax

Practice location:
  • Phone: 956-844-9199
  • Fax: 956-487-0486
Mailing address:
  • Phone: 956-844-9199
  • Fax: 956-487-0486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. CESAR VERA
Title or Position: CEO
Credential:
Phone: 956-844-9199