Provider Demographics
NPI:1083897151
Name:FAMILY IN FAITH ADULT DAY CARE, LLC
Entity Type:Organization
Organization Name:FAMILY IN FAITH ADULT DAY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAN JUANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:EUZEBIO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:956-399-7812
Mailing Address - Street 1:881 S SAM HOUSTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-3062
Mailing Address - Country:US
Mailing Address - Phone:956-399-7812
Mailing Address - Fax:956-388-2785
Practice Address - Street 1:881 S SAM HOUSTON BLVD
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-3062
Practice Address - Country:US
Practice Address - Phone:956-399-7812
Practice Address - Fax:956-388-2785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care