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General NPI Number Information
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NPI Number | 1639370752
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Entity Type | Organization
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Legal Business Name | EL CONCILIO ADULT DAY CARE, INC.
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 302 WASHINGTON ST
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City | LAREDO
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State | TX
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Zip | 78040-4544
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Country | US
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Telephone | 956-727-2169
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Fax |
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Provider Business Mailing Address
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Address Line | 1616 WASHINGTON ST
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City | LAREDO
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State | TX
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Zip | 78040-4464
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Country | US
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Telephone | 956-727-2169
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JORGE MADRIGALES
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Credential |
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Telephone | 956-727-2169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 115566
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License Number State | TX
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