Provider Demographics
NPI:1548558794
Name:VANGUARDIA ENTERPRISES, LLC
Entity Type:Organization
Organization Name:VANGUARDIA ENTERPRISES, LLC
Other - Org Name:MI GENTE ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO / OWNER / MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-217-2640
Mailing Address - Street 1:5510 N CAGE BLVD
Mailing Address - Street 2:STE N
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1812
Mailing Address - Country:US
Mailing Address - Phone:956-782-9803
Mailing Address - Fax:956-782-9009
Practice Address - Street 1:5510 N CAGE BLVD
Practice Address - Street 2:STE N
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-1812
Practice Address - Country:US
Practice Address - Phone:956-782-9803
Practice Address - Fax:956-782-9009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101863261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX101863Medicaid