Provider Demographics
NPI:1891022323
Name:ALDERETE ENTERPRISES LLC
Entity Type:Organization
Organization Name:ALDERETE ENTERPRISES LLC
Other - Org Name:DESSERT HEAVEN ADULT DAY CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DORA
Authorized Official - Middle Name:MARTINA
Authorized Official - Last Name:ROMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-422-8142
Mailing Address - Street 1:8615 SAN JUAN
Mailing Address - Street 2:BUILDING - 19
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907
Mailing Address - Country:US
Mailing Address - Phone:915-858-3703
Mailing Address - Fax:915-790-0026
Practice Address - Street 1:8615 SAN JUAN
Practice Address - Street 2:BUILDING - 19
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79907
Practice Address - Country:US
Practice Address - Phone:915-858-3703
Practice Address - Fax:915-790-0026
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALDERETE ENTERPISES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-04
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care