Provider Demographics
NPI:1326078791
Name:DONNA ADULT DAY CARE
Entity Type:Organization
Organization Name:DONNA ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ERNESTO
Authorized Official - Last Name:LUGO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:956-464-7741
Mailing Address - Street 1:2115 LOTT RD
Mailing Address - Street 2:
Mailing Address - City:DONNA
Mailing Address - State:TX
Mailing Address - Zip Code:78537-5633
Mailing Address - Country:US
Mailing Address - Phone:956-464-7741
Mailing Address - Fax:956-464-0007
Practice Address - Street 1:2 MILES SOUTH FM 493
Practice Address - Street 2:
Practice Address - City:DONNA
Practice Address - State:TX
Practice Address - Zip Code:78537
Practice Address - Country:US
Practice Address - Phone:956-464-0859
Practice Address - Fax:956-464-0007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115013261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7537006Medicaid
TXTX-108 6008Medicaid
TX115013Medicaid