Provider Demographics
NPI:1912196551
Name:GLORIA A. MONTALVO
Entity Type:Organization
Organization Name:GLORIA A. MONTALVO
Other - Org Name:PASEO DE ANGELITOS ADULT DAYCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CESARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTALVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-383-6202
Mailing Address - Street 1:4121 W STATE HIGHWAY 107
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-5836
Mailing Address - Country:US
Mailing Address - Phone:956-383-6202
Mailing Address - Fax:956-383-3231
Practice Address - Street 1:4121 W STATE HIGHWAY 107
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5836
Practice Address - Country:US
Practice Address - Phone:956-383-6202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120858261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care