Healthcare Provider Details

I. General information

NPI: 1487101234
Provider Name (Legal Business Name): SUNNY DAY CENTER ONE LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2016
Last Update Date: 08/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2714 OLD DALLAS RD
WACO TX
76705-1771
US

IV. Provider business mailing address

PO BOX 154846
WACO TX
76715-4846
US

V. Phone/Fax

Practice location:
  • Phone: 254-799-1099
  • Fax: 254-799-1786
Mailing address:
  • Phone: 254-799-1099
  • Fax: 254-799-1786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number143258
License Number StateTX

VIII. Authorized Official

Name: MRS. ADELIDE PEREZ YBARRA
Title or Position: OWNER
Credential:
Phone: 254-799-1099