| Organization Name: | AMISTAD ADULT DAY CARE |
| NPI Number: | 1053535690 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAQUEL G PINA (ONWER) |
| Mailing Address: | 636 W 3rd St Mercedes |
| State: | TX US |
| Postal Code: | 785703004 |
| Phone Number: | 9565141046 |
| Fax Number: | 9565141046 |
| NPI Enumeration Date: | 04/13/2007 |
| NPI Last Update Date: | 06/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA0600X |
| License Number: | 118479 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Day Care |
| Taxonomy Definition: | |