Provider Demographics
NPI:1619177391
Name:THE NEW 3RD HEAVEN ADULT DAY CARE LLC
Entity Type:Organization
Organization Name:THE NEW 3RD HEAVEN ADULT DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-519-9899
Mailing Address - Street 1:PO BOX 440
Mailing Address - Street 2:2308 EXPRESSWAY 83 SUITE D
Mailing Address - City:PENITAS
Mailing Address - State:TX
Mailing Address - Zip Code:78576-0440
Mailing Address - Country:US
Mailing Address - Phone:956-519-9899
Mailing Address - Fax:956-519-9881
Practice Address - Street 1:2308 EXPRESSWAY 83 STE D
Practice Address - Street 2:
Practice Address - City:PENITAS
Practice Address - State:TX
Practice Address - Zip Code:78576-8399
Practice Address - Country:US
Practice Address - Phone:956-519-9899
Practice Address - Fax:956-519-9881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120738311ZA0620X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home