Provider Demographics
NPI:1891865572
Name:LIVING DAYS ADULT DAY CARE CENTER, INC.
Entity Type:Organization
Organization Name:LIVING DAYS ADULT DAY CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MINDIETA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:210-977-9178
Mailing Address - Street 1:2603 W SOUTHCROSS BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78211-1850
Mailing Address - Country:US
Mailing Address - Phone:210-977-9178
Mailing Address - Fax:210-977-9205
Practice Address - Street 1:2603 W SOUTHCROSS BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-1850
Practice Address - Country:US
Practice Address - Phone:210-977-9178
Practice Address - Fax:210-977-9205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000330200Medicaid