| Organization Name: | CLARA SELENE PENA |
| NPI Number: | 1083928634 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CARLOS ANTONIO ORTIZ (DIRECTOR) |
| Mailing Address: | 401 Business 83 Ste D Donna |
| State: | TX US |
| Postal Code: | 785373088 |
| Phone Number: | 9564642386 |
| Fax Number: | |
| NPI Enumeration Date: | 08/05/2010 |
| NPI Last Update Date: | 08/05/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 311ZA0620X |
| License Number: | 130084 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Custodial Care Facility |
| Taxonomy Specialization: | Adult Care Home |
| Taxonomy Definition: | A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |