Provider Demographics
NPI:1073715371
Name:CELESTIAL ADULT DAY CARE, INC.
Entity Type:Organization
Organization Name:CELESTIAL ADULT DAY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ALFREDO
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-787-1451
Mailing Address - Street 1:301 N CAGE BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-3966
Mailing Address - Country:US
Mailing Address - Phone:956-787-1451
Mailing Address - Fax:956-787-1457
Practice Address - Street 1:301 N CAGE BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-3966
Practice Address - Country:US
Practice Address - Phone:956-787-1451
Practice Address - Fax:956-787-1457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102519251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services