Provider Demographics
NPI:1427352822
Name:CONCHITA'S ADULT DAY CARE, L.L.C.
Entity type:Organization
Organization Name:CONCHITA'S ADULT DAY CARE, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BUTCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-566-9939
Mailing Address - Street 1:1003 E RINGGOLD ST
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-3413
Mailing Address - Country:US
Mailing Address - Phone:956-566-9939
Mailing Address - Fax:
Practice Address - Street 1:1003 E RINGGOLD ST
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-3413
Practice Address - Country:US
Practice Address - Phone:956-566-9939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-29
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care