Provider Demographics
NPI:1801363163
Name:LA CASA DE SUSY ADULT DAY CARE, LLC
Entity Type:Organization
Organization Name:LA CASA DE SUSY ADULT DAY CARE, LLC
Other - Org Name:LINDO AMANECER ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SAN JUANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-352-1010
Mailing Address - Street 1:5105 S EMBASSY ST
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-6657
Mailing Address - Country:US
Mailing Address - Phone:956-352-1010
Mailing Address - Fax:956-352-1020
Practice Address - Street 1:5105 S EMBASSY ST
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-6657
Practice Address - Country:US
Practice Address - Phone:956-352-6220
Practice Address - Fax:956-352-6240
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LA CASA DE SUSY ADULT DAY CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-25
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care