Provider Demographics
NPI:1689995037
Name:TEXAS SENIOR & DISABLED DAY CARE, L.L.C.
Entity Type:Organization
Organization Name:TEXAS SENIOR & DISABLED DAY CARE, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:RAUL
Authorized Official - Last Name:PADILLA
Authorized Official - Suffix:JR
Authorized Official - Credentials:BS
Authorized Official - Phone:915-592-3100
Mailing Address - Street 1:1223 N LEE TREVINO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-1548
Mailing Address - Country:US
Mailing Address - Phone:915-592-3100
Mailing Address - Fax:915-592-3110
Practice Address - Street 1:1223 N. LEE TREVINO DR.
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79907
Practice Address - Country:US
Practice Address - Phone:915-592-3100
Practice Address - Fax:915-592-3110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA129696261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care