Provider Demographics
NPI:1144566860
Name:DAZ & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DAZ & ASSOCIATES, LLC
Other - Org Name:GENESIS HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADRIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-350-2300
Mailing Address - Street 1:1213 E ALTON GLOOR BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3906
Mailing Address - Country:US
Mailing Address - Phone:956-350-2300
Mailing Address - Fax:956-350-2185
Practice Address - Street 1:1213 E ALTON GLOOR BLVD STE E
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-3906
Practice Address - Country:US
Practice Address - Phone:956-350-2300
Practice Address - Fax:956-350-2185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-27
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX015613251E00000X
251J00000X, 253Z00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing CareGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX371873601Medicaid