Provider Demographics
NPI:1316379795
Name:DOUBLE CROWN CASTLE INC
Entity Type:Organization
Organization Name:DOUBLE CROWN CASTLE INC
Other - Org Name:LA PALOMA DAY HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-592-5222
Mailing Address - Street 1:1212 N 14TH ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:KINGSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78363-4013
Mailing Address - Country:US
Mailing Address - Phone:361-592-5222
Mailing Address - Fax:361-592-5639
Practice Address - Street 1:1212 N 14TH ST
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363-4013
Practice Address - Country:US
Practice Address - Phone:361-592-1299
Practice Address - Fax:361-592-1517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000328200261QA0600X
TX000345500261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care