Provider Demographics
NPI:1346702107
Name:MIS VERDADEROS AMIGOS ADULT DAY CARE, LLC
Entity Type:Organization
Organization Name:MIS VERDADEROS AMIGOS ADULT DAY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROMEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLARREAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-432-5501
Mailing Address - Street 1:123 W MILE 3 RD STE 106
Mailing Address - Street 2:
Mailing Address - City:PALMHURST
Mailing Address - State:TX
Mailing Address - Zip Code:78573-1709
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:123 W MILE 3 RD STE 106
Practice Address - Street 2:
Practice Address - City:PALMHURST
Practice Address - State:TX
Practice Address - Zip Code:78573-1709
Practice Address - Country:US
Practice Address - Phone:956-432-5501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-02
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care