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General NPI Number Information
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NPI Number | 1679761985
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Entity Type | Organization
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Legal Business Name | MI GENERACION ADULT DAY CARE INC.
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 08/29/2018
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Provider Practice Location Address
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Address Line | 1603 W. EXPRESSWAY 83 / GUADALUPE FLORES ROAD.
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City | SULLIVAN CITY
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State | TX
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Zip | 78595
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Country | US
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Telephone | 956-573-4471
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Fax | 956-686-7577
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Provider Business Mailing Address
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Address Line | P.O. BOX 623
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City | SULLIVAN CITY
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State | TX
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Zip | 78595
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Country | US
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Telephone | 956-573-4471
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Fax | 956-686-7577
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Authorized Official
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Title or Position | OWNER
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Name | MS. CECILIA Y. CHAPA
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Credential | ADMINISTRATOR
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Telephone | 956-573-4471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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