MEDICARE: EXCLUSIVE ADULT DAY CARE INC

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

General Provider Information

NPI Number	:	1386855641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCLUSIVE ADULT DAY CARE INC

Provider Business Mailing Address
First Line	:	6810 BANDERA RD
Second Line	:	STE 01
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-1468
Country	:	US
Telephone Number	:	210-522-0911
Fax Number	:	210-523-0911

Provider Business Practice Location Address
First Line	:	6810 BANDERA RD
Second Line	:	STE 01
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-1468
Country	:	US
Telephone Number	:	210-522-0911
Fax Number	:	210-523-0911

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LUCY I RIOS
Credential	:
Telephone Number	:	210-521-8776

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	07/26/2019

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