Provider Demographics
NPI:1750934931
Name:CNV ADULT DAY CARE LLP
Entity type:Organization
Organization Name:CNV ADULT DAY CARE LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PASTOR
Authorized Official - Phone:915-999-9187
Mailing Address - Street 1:11320 IVANHOE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-1211
Mailing Address - Country:US
Mailing Address - Phone:915-300-9523
Mailing Address - Fax:915-288-4531
Practice Address - Street 1:11627 SOCORRO RD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79927-3058
Practice Address - Country:US
Practice Address - Phone:915-999-9187
Practice Address - Fax:915-288-4531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5891025Medicaid