| Organization Name: | PALM VILLA ADULT DAYCARE FACILITY |
| NPI Number: | 1700014073 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELIZABETH MEDINA (CEO) |
| Mailing Address: | 2308 Hwy 83 Ste D Penitas |
| State: | TX US |
| Postal Code: | 785768399 |
| Phone Number: | 9565846700 |
| Fax Number: | 9565837793 |
| NPI Enumeration Date: | 06/25/2009 |
| NPI Last Update Date: | 06/25/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA0600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Day Care |
| Taxonomy Definition: | |