Provider Demographics
NPI:1376663682
Name:PELE ENTERPRIZEZ, LLC
Entity Type:Organization
Organization Name:PELE ENTERPRIZEZ, LLC
Other - Org Name:EL PEDACITO ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FACILITY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ELVIA
Authorized Official - Last Name:VILLAREAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-542-4433
Mailing Address - Street 1:1354 PALM BLVD SUITE #5
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520
Mailing Address - Country:US
Mailing Address - Phone:956-542-4433
Mailing Address - Fax:956-542-8454
Practice Address - Street 1:1354 PALM BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520
Practice Address - Country:US
Practice Address - Phone:956-542-4433
Practice Address - Fax:956-542-8454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102874261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care