Provider Demographics
NPI:1083817316
Name:GALVESTON COUNTY ADULT DAYCARE INC.
Entity Type:Organization
Organization Name:GALVESTON COUNTY ADULT DAYCARE INC.
Other - Org Name:GAL. CO. ADULT DAYCARE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:409-945-4414
Mailing Address - Street 1:2120 TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77590-8338
Mailing Address - Country:US
Mailing Address - Phone:409-945-4414
Mailing Address - Fax:409-945-3141
Practice Address - Street 1:2120 TEXAS AVE
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77590-8338
Practice Address - Country:US
Practice Address - Phone:409-945-4414
Practice Address - Fax:409-945-3141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1760455781300Medicaid