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General NPI Number Information
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NPI Number | 1891079505
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Entity Type | Organization
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Legal Business Name | KORAZONCITO DE MI AMOR ADULT DAY CARE CENTER INC.
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Dates
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Enumeration Date | 09/30/2011
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Last Update Date | 09/30/2011
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Provider Practice Location Address
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Address Line | 292 KINGS HWY STE 4-7 292 KINGS HWY STE 6
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City | BROWNSVILLE
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State | TX
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Zip | 78521-4265
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Country | US
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Telephone | 956-542-2035
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Fax | 956-542-2036
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Provider Business Mailing Address
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Address Line | 292 KINGS HWY STE 4-7 1945 E. HARRISON STREET
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City | BROWNSVILLE
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State | TX
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Zip | 78521-4265
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Country | US
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Telephone | 956-542-2035
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Fax | 956-542-2036
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MS. ADRIANA VELEZ
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Credential |
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Telephone | 956-639-1775
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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 | 132735
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License Number State | TX
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