MEDICARE: LA PALOMA DAY HEALTH SERVICES CORP

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	:	1588731145
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LA PALOMA DAY HEALTH SERVICES CORP

Provider Business Mailing Address
First Line	:	1212 N 14TH ST
Second Line	:	SUITE 3
City	:	KINGSVILLE
State	:	TX
Zip	:	78363-4013
Country	:	US
Telephone Number	:	361-592-5222
Fax Number	:	361-592-5639

Provider Business Practice Location Address
First Line	:	312 E KINNEY ST
Second Line	:
City	:	CRYSTAL CITY
State	:	TX
Zip	:	78839-2916
Country	:	US
Telephone Number	:	830-374-5152
Fax Number	:	830-374-5193

Authorized Official
Title or Position	:	ACCOUNTANT CORPORATE SECRETARY
Name	:	MR. JOE HENRY DELGADO
Credential	:
Telephone Number	:	361-592-5222

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	08/22/2020

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Directions to “LA PALOMA DAY HEALTH SERVICES CORP ” Practice Location

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