Provider Demographics
NPI:1578895413
Name:EMMANUEL ADULT DAY CARE 2
Entity Type:Organization
Organization Name:EMMANUEL ADULT DAY CARE 2
Other - Org Name:ADELILYA GARICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADELILYA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-580-0033
Mailing Address - Street 1:801 N CONWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-5361
Mailing Address - Country:US
Mailing Address - Phone:956-585-0950
Mailing Address - Fax:956-580-1858
Practice Address - Street 1:801 N CONWAY AVE
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-5361
Practice Address - Country:US
Practice Address - Phone:956-585-0950
Practice Address - Fax:956-580-1858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX128848305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service