Provider Demographics
NPI:1114100609
Name:COMMUNITY ADULT DAY ACTIVITY & HEALTH CENTER
Entity Type:Organization
Organization Name:COMMUNITY ADULT DAY ACTIVITY & HEALTH CENTER
Other - Org Name:CADAHC INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MELBA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:903-935-1610
Mailing Address - Street 1:1305 S. WASHINGTON AVE.
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75670-6215
Mailing Address - Country:US
Mailing Address - Phone:903-935-1610
Mailing Address - Fax:903-935-8024
Practice Address - Street 1:1305 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75670-6215
Practice Address - Country:US
Practice Address - Phone:903-935-1610
Practice Address - Fax:903-935-8024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA0600X
TX120391313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility