Provider Demographics
NPI:1235342189
Name:EL RECREO LLC
Entity Type:Organization
Organization Name:EL RECREO LLC
Other - Org Name:EL RECREO ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FACILITY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-821-4111
Mailing Address - Street 1:PO BOX 2763
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-2763
Mailing Address - Country:US
Mailing Address - Phone:956-821-4111
Mailing Address - Fax:
Practice Address - Street 1:1618 N VETERANS BLVD STE F
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589-3221
Practice Address - Country:US
Practice Address - Phone:956-782-0300
Practice Address - Fax:956-782-6230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA0600X
TX118892305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No305S00000XManaged Care OrganizationsPoint of Service