Provider Demographics
NPI:1093911521
Name:MI TESORO ADULT DAY CARE
Entity Type:Organization
Organization Name:MI TESORO ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIBEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLALPANDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-262-6262
Mailing Address - Street 1:PO BOX 2367
Mailing Address - Street 2:
Mailing Address - City:ELSA
Mailing Address - State:TX
Mailing Address - Zip Code:78543-2367
Mailing Address - Country:US
Mailing Address - Phone:956-262-6262
Mailing Address - Fax:956-262-0606
Practice Address - Street 1:315 N BROADWAY
Practice Address - Street 2:
Practice Address - City:ELSA
Practice Address - State:TX
Practice Address - Zip Code:78543
Practice Address - Country:US
Practice Address - Phone:956-262-6262
Practice Address - Fax:956-262-0606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services