Provider Demographics
NPI:1407162167
Name:ELIAZAR RODRIGUEZ DBA LA PALMA ADULT DAY CARE
Entity Type:Organization
Organization Name:ELIAZAR RODRIGUEZ DBA LA PALMA ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ELIAZAR
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-262-8300
Mailing Address - Street 1:PO BOX 1614
Mailing Address - Street 2:
Mailing Address - City:ELSA
Mailing Address - State:TX
Mailing Address - Zip Code:78543-1614
Mailing Address - Country:US
Mailing Address - Phone:956-262-8300
Mailing Address - Fax:956-262-8302
Practice Address - Street 1:610 N. BROADWAY,
Practice Address - Street 2:STE A
Practice Address - City:ELSA
Practice Address - State:TX
Practice Address - Zip Code:78543
Practice Address - Country:US
Practice Address - Phone:956-262-8300
Practice Address - Fax:956-262-8302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services