Provider Demographics
NPI:1114095882
Name:SIMCHA, INC.
Entity Type:Organization
Organization Name:SIMCHA, INC.
Other - Org Name:MI JARDIN ADULT DAY CARE #2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:VELA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:956-519-1339
Mailing Address - Street 1:5400 MAVERICK RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-6303
Mailing Address - Country:US
Mailing Address - Phone:956-982-1339
Mailing Address - Fax:956-982-0644
Practice Address - Street 1:5400 MAVERICK RD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-6303
Practice Address - Country:US
Practice Address - Phone:956-982-1339
Practice Address - Fax:956-982-0644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130680OtherDEPARTMENT OF AGING AND DISABILITY SERVICES, ADC LICENSE NUMBER
TX003079OtherDEPARTMENT OF AGING AND DISABILITY SERVICES, ADC VENDOR/FACILITY ID
TX000307900Medicaid