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General NPI Number Information
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NPI Number | 1154627818
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Entity Type | Organization
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Legal Business Name | GUIDANCE & COUNSELING ASSOCIATES OF LAREDO LLC
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Dates
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Enumeration Date | 01/28/2011
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Last Update Date | 04/09/2011
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Provider Practice Location Address
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Address Line | 6510 POLARIS DR STE 2 UNIT 10
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City | LAREDO
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State | TX
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Zip | 78041
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Country | US
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Telephone | 956-284-0779
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 451315
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City | LAREDO
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State | TX
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Zip | 78045-0032
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Country | US
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Telephone | 956-284-0779
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELIA ELIZA DAVILA
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Credential | LCSW
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Telephone | 956-284-0779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 23884
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 23884
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License Number State | TX
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