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General NPI Number Information
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NPI Number | 1770515561
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Entity Type | Organization
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Legal Business Name | MAVERICK ADULT DAY CARE LLC.
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 2557 N VETERANS BLVD STE E
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City | EAGLE PASS
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State | TX
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Zip | 78852-3390
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Country | US
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Telephone | 830-757-0966
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Fax | 830-757-0976
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Provider Business Mailing Address
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Address Line | 2557 N VETERANS BLVD STE E
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City | EAGLE PASS
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State | TX
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Zip | 78852-3390
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Country | US
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Telephone | 830-757-0966
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Fax | 830-757-0976
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Authorized Official
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Title or Position | CFO
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Name | MR. GERARDO VILLALPANDO
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Credential |
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Telephone | 830-757-0966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 009852
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 009852
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License Number State | TX
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