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General NPI Number Information
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NPI Number | 1588125868
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Entity Type | Organization
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Legal Business Name | CECILIA TERRES ETERNAL YOUTH HOME 2
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Dates
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Enumeration Date | 03/28/2019
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Last Update Date | 03/28/2019
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Provider Practice Location Address
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Address Line | 11651 CLEAR LAKE WAY
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City | EL PASO
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State | TX
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Zip | 79936-4382
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Country | US
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Telephone | 915-921-6752
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Fax | 915-633-1994
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Provider Business Mailing Address
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Address Line | 11651 CLEAR LAKE WAY
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City | EL PASO
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State | TX
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Zip | 79936-4382
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Country | US
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Telephone | 915-921-6752
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Fax | 915-633-1994
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Authorized Official
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Title or Position | OWNER
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Name | CECILIA TERRES
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Credential |
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Telephone | 915-921-6752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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