Provider Demographics
NPI:1689370108
Name:LA TRINIDAD ADULT DAY CARE, LLC.
Entity Type:Organization
Organization Name:LA TRINIDAD ADULT DAY CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-600-8055
Mailing Address - Street 1:1304 W VETERANS BLVD
Mailing Address - Street 2:
Mailing Address - City:PALMVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:78572-8115
Mailing Address - Country:US
Mailing Address - Phone:956-600-8055
Mailing Address - Fax:
Practice Address - Street 1:1304 W VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:PALMVIEW
Practice Address - State:TX
Practice Address - Zip Code:78572-8115
Practice Address - Country:US
Practice Address - Phone:956-600-8055
Practice Address - Fax:956-600-7366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care