Healthcare Provider Details

I. General information

NPI: 1851575682
Provider Name (Legal Business Name): VILLA DORADA DAY CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2007
Last Update Date: 08/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3849 W US HIGHWAY 83
RIO GRANDE CITY TX
78582
US

IV. Provider business mailing address

3849 W. HWY. 83
RIO GRANDE CITY TX
78582
US

V. Phone/Fax

Practice location:
  • Phone: 956-487-5752
  • Fax: 956-487-5709
Mailing address:
  • Phone: 956-487-5752
  • Fax: 956-487-5709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number133535
License Number StateTX

VIII. Authorized Official

Name: MRS. MARY ELIZABETH GARZA
Title or Position: PRESIDENT
Credential:
Phone: 956-487-5752