Provider Demographics
NPI:1720261068
Name:VERONICA DE LA CRUZ
Entity Type:Organization
Organization Name:VERONICA DE LA CRUZ
Other - Org Name:LOS ANGELITOS ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-376-3381
Mailing Address - Street 1:920 W STATE STREET
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577
Mailing Address - Country:US
Mailing Address - Phone:956-283-9822
Mailing Address - Fax:956-283-9822
Practice Address - Street 1:920 W STATE STREET
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577
Practice Address - Country:US
Practice Address - Phone:956-283-9822
Practice Address - Fax:956-283-9822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121237261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001014622Medicaid