Provider Demographics
NPI:1225282106
Name:REFUGIO SENIOR CENTER
Entity Type:Organization
Organization Name:REFUGIO SENIOR CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:URIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ENRIQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-465-0491
Mailing Address - Street 1:303 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76164-9131
Mailing Address - Country:US
Mailing Address - Phone:972-465-0491
Mailing Address - Fax:
Practice Address - Street 1:303 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76164-9131
Practice Address - Country:US
Practice Address - Phone:972-465-0491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MANAGING MEMBER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX302R00000X, 311ZA0620X, 343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home