Organization Name: | LA ESPERANZA ADULT ACTIVITY CENTER |
NPI Number: | 1164628731 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROSIE COFFEEN (OWNER) |
Mailing Address: | 302 Moore St Beeville |
State: | TX US |
Postal Code: | 781026928 |
Phone Number: | 3613624999 |
Fax Number: | 3613624994 |
NPI Enumeration Date: | 06/21/2007 |
NPI Last Update Date: | 12/22/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA0600X |
License Number: | 050755 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Day Care |
Taxonomy Definition: |