Provider Demographics
NPI:1003064619
Name:BELLO AMANECER ADULT DAY, INC.
Entity Type:Organization
Organization Name:BELLO AMANECER ADULT DAY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIDIA
Authorized Official - Middle Name:BEATRIZ
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-542-5817
Mailing Address - Street 1:556 W ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-6388
Mailing Address - Country:US
Mailing Address - Phone:956-542-5817
Mailing Address - Fax:956-542-5981
Practice Address - Street 1:556 W ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-6388
Practice Address - Country:US
Practice Address - Phone:956-542-5817
Practice Address - Fax:956-542-5981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103479261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103479OtherTEXAS DEPT PF AGING & DISABILITY SERVICES