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General NPI Number Information
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NPI Number | 1831397165
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Entity Type | Organization
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Legal Business Name | RIVERSIDE ADULT DAY CARE, INC
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Dates
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Enumeration Date | 07/09/2007
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Last Update Date | 10/23/2018
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Provider Practice Location Address
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Address Line | 1474 W PRICE RD SUITE # 1
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City | BROWNSVILLE
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State | TX
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Zip | 78520-8687
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Country | US
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Telephone | 956-504-1799
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Fax | 956-504-2070
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Provider Business Mailing Address
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Address Line | 1474 W. PRICE RD STE 1
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City | BROWNSVILLE
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State | TX
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Zip | 78520
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Country | US
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Telephone | 956-504-1799
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Fax | 956-504-2070
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | HUGO ERICK SEGOVIANO
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Credential |
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Telephone | 956-504-1799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 120365
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | DADS147869
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License Number State | TX
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Taxonomy #4
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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 |
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