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General NPI Number Information
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NPI Number | 1326390949
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Entity Type | Organization
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Legal Business Name | MUNDO DE AMOR ADULT DAY CARE, LLC.
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Dates
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Enumeration Date | 10/05/2012
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Last Update Date | 03/17/2020
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Provider Practice Location Address
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Address Line | 4606 E SOUTHCROSS BLVD # 103
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City | SAN ANTONIO
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State | TX
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Zip | 78222-4911
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Country | US
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Telephone | 210-648-0238
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Fax | 844-274-1062
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Provider Business Mailing Address
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Address Line | 4606 E SOUTHCROSS BLVD 102
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City | SAN ANTONIO
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State | TX
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Zip | 78222-4911
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMIN
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Name | MRS. EVELYN DIAZ
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Credential |
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Telephone | 210-896-8139
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State | TX
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