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General NPI Number Information
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NPI Number | 1649619446
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Entity Type | Organization
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Legal Business Name | DOMINION SENIOR SERVICES, LLC
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Dates
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Enumeration Date | 06/14/2013
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Last Update Date | 06/14/2013
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Provider Practice Location Address
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Address Line | 6419 MCPHERSON RD STE H
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City | LAREDO
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State | TX
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Zip | 78041-6215
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Country | US
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Telephone | 956-568-3979
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Fax | 956-568-4014
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Provider Business Mailing Address
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Address Line | 6419 MCPHERSON RD STE H
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City | LAREDO
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State | TX
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Zip | 78041-6215
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Country | US
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Telephone | 956-568-3979
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Fax | 956-568-4014
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Authorized Official
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Title or Position | OWNER
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Name | MARIA ELENA HINOJOSA
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Credential |
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Telephone | 956-568-3979
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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 | 136846
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License Number State | TX
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