MEDICARE: EL CHAPARRAL ADULT DAY CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center		TX

General Provider Information

NPI Number	:	1063742351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL CHAPARRAL ADULT DAY CARE LLC

Provider Business Mailing Address
First Line	:	3700 W. 5 MILE LN.
Second Line	:
City	:	MISSION
State	:	TX
Zip	:	78574
Country	:	US
Telephone Number	:	956-566-5811
Fax Number	:	956-519-9881

Provider Business Practice Location Address
First Line	:	3700 W. 5 MILE LN
Second Line	:
City	:	MISSION
State	:	TX
Zip	:	78574
Country	:	US
Telephone Number	:	956-566-5811
Fax Number	:	956-519-9881

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. RAQUEL RODRIGUEZ
Credential	:
Telephone Number	:	956-566-5811

Provider Enumeration Date	:	01/08/2010
Last Update Date	:	01/08/2010

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