Provider Demographics
NPI:1922246172
Name:MIS RECUERDOS ADULT DAY CARE
Entity Type:Organization
Organization Name:MIS RECUERDOS ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:ALICIA
Authorized Official - Last Name:CASTRELLON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-289-1876
Mailing Address - Street 1:PO BOX 2763
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78540-2763
Mailing Address - Country:US
Mailing Address - Phone:956-289-1876
Mailing Address - Fax:956-289-8049
Practice Address - Street 1:2804 N. MCCOLL
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539
Practice Address - Country:US
Practice Address - Phone:956-289-1876
Practice Address - Fax:956-289-8049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103581261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care