MEDICARE: AHORA Y SIEMPRE 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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1598084774
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AHORA Y SIEMPRE INC

Provider Business Mailing Address
First Line	:	800 ROSS AVE APT 4114
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75202-1828
Country	:	US
Telephone Number	:	817-521-9723
Fax Number	:	214-272-8253

Provider Business Practice Location Address
First Line	:	800 ROSS AVE APT 4114
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75202-1828
Country	:	US
Telephone Number	:	817-521-9723
Fax Number	:	214-272-8253

Authorized Official
Title or Position	:	PROGRAM MANAGER
Name	:	FRANCISCO GONZALEZ
Credential	:
Telephone Number	:	817-521-9723

Provider Enumeration Date	:	05/26/2010
Last Update Date	:	05/26/2010

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