Provider Demographics
NPI:1376707166
Name:PREFERRED ADULT DAY CARE CENTER LLC
Entity type:Organization
Organization Name:PREFERRED ADULT DAY CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:CRUZ
Authorized Official - Last Name:FERREL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-857-5029
Mailing Address - Street 1:2104 BEACH FRONT DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-3917
Mailing Address - Country:US
Mailing Address - Phone:915-857-5029
Mailing Address - Fax:
Practice Address - Street 1:8825 NORTH LOOP
Practice Address - Street 2:SUITES 118-119
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79907
Practice Address - Country:US
Practice Address - Phone:915-857-5029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care