Provider Demographics
NPI:1932301249
Name:MARYLOU
Entity Type:Organization
Organization Name:MARYLOU
Other - Org Name:UN DIA A LA VEZ ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARYLOU
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-783-8996
Mailing Address - Street 1:5201 N RAUL LONGORIA RD STE ABC
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-4078
Mailing Address - Country:US
Mailing Address - Phone:956-783-8996
Mailing Address - Fax:956-783-8992
Practice Address - Street 1:5201 N RAUL LONGORIA RD STE ABC
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589-4078
Practice Address - Country:US
Practice Address - Phone:956-783-8996
Practice Address - Fax:956-783-8992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care