Provider Demographics
NPI:1376061432
Name:MARIA TERESA NAVARRETE
Entity Type:Organization
Organization Name:MARIA TERESA NAVARRETE
Other - Org Name:LA GAVIOTA FOSTER HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:NAVARRETE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-355-4091
Mailing Address - Street 1:1207 E YANDELL DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-5526
Mailing Address - Country:US
Mailing Address - Phone:915-355-4091
Mailing Address - Fax:
Practice Address - Street 1:6217 MONARCH DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-4924
Practice Address - Country:US
Practice Address - Phone:915-238-6206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-08
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home