Provider Demographics
NPI:1750458006
Name:HACIENDA DE PALMAS
Entity Type:Organization
Organization Name:HACIENDA DE PALMAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ROSARIO
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-292-0035
Mailing Address - Street 1:4211 W UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-9461
Mailing Address - Country:US
Mailing Address - Phone:956-292-0035
Mailing Address - Fax:956-292-0726
Practice Address - Street 1:4211 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9461
Practice Address - Country:US
Practice Address - Phone:956-292-0035
Practice Address - Fax:956-292-0726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care