Provider Demographics
NPI:1093884728
Name:WKCG INC
Entity Type:Organization
Organization Name:WKCG INC
Other - Org Name:NEW AWAKENINGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO PROGRAM DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:DALILA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLARREAL
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELOR OF ARTS BA
Authorized Official - Phone:956-550-9690
Mailing Address - Street 1:3670 BOCA CHICA BLVD
Mailing Address - Street 2:STE 7
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521
Mailing Address - Country:US
Mailing Address - Phone:956-550-9690
Mailing Address - Fax:956-550-9694
Practice Address - Street 1:3670 BOCA CHICA BLVD
Practice Address - Street 2:STE 7
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521
Practice Address - Country:US
Practice Address - Phone:956-550-9690
Practice Address - Fax:956-550-9694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered251J00000XAgenciesNursing Care