MEDICARE: ROMELIA VIGIL DBA STRAWBERRY PATCH ADC

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	:	1134288038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROMELIA VIGIL DBA STRAWBERRY PATCH ADC

Provider Business Mailing Address
First Line	:	1605 N 6TH ST
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78501-2213
Country	:	US
Telephone Number	:	956-682-4054
Fax Number	:	956-994-0601

Provider Business Practice Location Address
First Line	:	1605 N 6TH ST
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78501-2213
Country	:	US
Telephone Number	:	956-682-4054
Fax Number	:	956-994-0601

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. ROMIE VIGIL
Credential	:
Telephone Number	:	956-682-4054

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	08/22/2020

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