Provider Demographics
NPI:1750637351
Name:EPOCA DE ORO ADULT DAY CARE, LLC
Entity Type:Organization
Organization Name:EPOCA DE ORO ADULT DAY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:
Authorized Official - First Name:LILIA
Authorized Official - Middle Name:MARISOL
Authorized Official - Last Name:BENITEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-424-0124
Mailing Address - Street 1:915 N. LA HOMA RD.
Mailing Address - Street 2:
Mailing Address - City:PALMVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:78574
Mailing Address - Country:US
Mailing Address - Phone:956-424-0124
Mailing Address - Fax:956-424-0292
Practice Address - Street 1:915 N. LA HOMA RD.
Practice Address - Street 2:
Practice Address - City:PALMVIEW
Practice Address - State:TX
Practice Address - Zip Code:78574
Practice Address - Country:US
Practice Address - Phone:956-424-0124
Practice Address - Fax:956-424-0292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-01
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care