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General NPI Number Information
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NPI Number | 1063554780
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Entity Type | Organization
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Legal Business Name | LOVINGADULTDAYCARECENTER,INC.
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 1560 W WHEELER STE E
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City | ARANSAS PASS
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State | TX
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Zip | 78336-4556
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Country | US
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Telephone | 361-758-3001
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Fax | 361-758-5381
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Provider Business Mailing Address
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Address Line | 1560 W WHEELER STE E
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City | ARANSAS PASS
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State | TX
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Zip | 78336-4556
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Country | US
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Telephone | 361-758-3001
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Fax | 361-758-5381
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Authorized Official
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Title or Position | OWNER
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Name | HOLLY N VAN DORN
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Credential |
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Telephone | 361-758-3001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | 7428273360
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License Number State | TX
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