Provider Demographics
NPI:1477784577
Name:CROSSROADS AULT DAY CARE LLC
Entity Type:Organization
Organization Name:CROSSROADS AULT DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN CONSULTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:SALDIVAR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-487-3700
Mailing Address - Street 1:202 N. FLORES
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582
Mailing Address - Country:US
Mailing Address - Phone:956-487-3700
Mailing Address - Fax:956-487-3700
Practice Address - Street 1:202 N FLORES ST
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-3851
Practice Address - Country:US
Practice Address - Phone:956-487-3700
Practice Address - Fax:956-487-3700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPENDINGMedicaid