Provider Demographics
NPI:1164858403
Name:MOSV INC
Entity Type:Organization
Organization Name:MOSV INC
Other - Org Name:FOUNTAIN OF LIFE ADULT ACTIVITY CENTER #2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ORALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-212-2379
Mailing Address - Street 1:2308 SILVERADO NORTH
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78573
Mailing Address - Country:US
Mailing Address - Phone:956-212-2379
Mailing Address - Fax:
Practice Address - Street 1:1003 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HALE CENTER
Practice Address - State:TX
Practice Address - Zip Code:79041
Practice Address - Country:US
Practice Address - Phone:806-839-2541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care