Provider Demographics
NPI:1639447709
Name:VIDA BENDITA ADULT DAY CARE, LLC
Entity Type:Organization
Organization Name:VIDA BENDITA ADULT DAY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/RN
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-208-6871
Mailing Address - Street 1:2911 ALPHA ST.
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:956-208-6871
Mailing Address - Fax:956-847-2965
Practice Address - Street 1:2911 ALPHA ST.
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582
Practice Address - Country:US
Practice Address - Phone:956-208-6871
Practice Address - Fax:956-847-2965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care