Provider Demographics
NPI:1952516056
Name:FESTIVA INC.
Entity Type:Organization
Organization Name:FESTIVA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:956-630-6111
Mailing Address - Street 1:3900 W EXPRESSWAY 83
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-8425
Mailing Address - Country:US
Mailing Address - Phone:956-630-6111
Mailing Address - Fax:956-630-6171
Practice Address - Street 1:3900 W EXPRESSWAY 83
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-8425
Practice Address - Country:US
Practice Address - Phone:956-630-6111
Practice Address - Fax:956-630-6171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120159261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care