Provider Demographics
NPI:1972784775
Name:NACM
Entity Type:Organization
Organization Name:NACM
Other - Org Name:LA GLORIA ADULT DAY CARE, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NORA
Authorized Official - Middle Name:S
Authorized Official - Last Name:ALANIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-580-8935
Mailing Address - Street 1:801 N CONWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-5361
Mailing Address - Country:US
Mailing Address - Phone:956-580-8935
Mailing Address - Fax:956-580-9613
Practice Address - Street 1:801 N CONWAY AVE
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-5361
Practice Address - Country:US
Practice Address - Phone:956-580-8935
Practice Address - Fax:956-580-9613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120705313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120705Medicaid