Provider Demographics
NPI:1033248620
Name:ADULT ENRICHMENT CENTER, INC.
Entity Type:Organization
Organization Name:ADULT ENRICHMENT CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSEQUETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-942-9253
Mailing Address - Street 1:6146 APPALOOSA TRL
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76901-4920
Mailing Address - Country:US
Mailing Address - Phone:325-942-9253
Mailing Address - Fax:325-944-0331
Practice Address - Street 1:6146 APPALOOSA TRL
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901-4920
Practice Address - Country:US
Practice Address - Phone:325-942-9253
Practice Address - Fax:325-944-0331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care