Healthcare Provider Details

I. General information

NPI: 1568793735
Provider Name (Legal Business Name): MY SWEET HOME ADULT DAY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2010
Last Update Date: 01/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1691 E SAN BENITO ST STE B
RIO GRANDE CITY TX
78582-3401
US

IV. Provider business mailing address

1691 E SAN BENITO ST STE B
RIO GRANDE CITY TX
78582-3401
US

V. Phone/Fax

Practice location:
  • Phone: 956-488-1255
  • Fax: 956-487-7988
Mailing address:
  • Phone: 956-488-1255
  • Fax: 956-487-7988

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. ERNESTO GARCIA
Title or Position: ADMINISTRATOR
Credential:
Phone: 956-488-1255