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General NPI Number Information
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NPI Number | 1639447709
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Entity Type | Organization
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Legal Business Name | VIDA BENDITA ADULT DAY CARE, LLC
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Dates
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Enumeration Date | 12/05/2011
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Last Update Date | 12/05/2011
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Provider Practice Location Address
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Address Line | 2911 ALPHA ST.
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582
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Country | US
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Telephone | 956-208-6871
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Fax | 956-847-2965
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Provider Business Mailing Address
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Address Line | 2911 ALPHA ST.
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582
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Country | US
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Telephone | 956-208-6871
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Fax | 956-847-2965
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Authorized Official
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Title or Position | DIRECTOR/RN
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Name | MRS. DANIRA TREVINO
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Credential |
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Telephone | 956-208-6871
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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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