Provider Demographics
NPI:1013205699
Name:GABRIELA AGUILLON
Entity Type:Organization
Organization Name:GABRIELA AGUILLON
Other - Org Name:THE GOOD LIFE ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-381-0906
Mailing Address - Street 1:521 S 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-4601
Mailing Address - Country:US
Mailing Address - Phone:956-380-0461
Mailing Address - Fax:956-287-4744
Practice Address - Street 1:304 E CANO ST
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-4512
Practice Address - Country:US
Practice Address - Phone:956-381-0906
Practice Address - Fax:956-386-0330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-15
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104700310400000X
TX0171273747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living FacilityGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty