Provider Demographics
NPI:1811073570
Name:CASA DE RECUERDOS, LLC
Entity type:Organization
Organization Name:CASA DE RECUERDOS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-583-5837
Mailing Address - Street 1:205 W VETERANS BLVD
Mailing Address - Street 2:STE. 2
Mailing Address - City:PALMVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:78572-8158
Mailing Address - Country:US
Mailing Address - Phone:956-583-5837
Mailing Address - Fax:956-583-2727
Practice Address - Street 1:205 W VETERANS BLVD
Practice Address - Street 2:STE. 2
Practice Address - City:PALMVIEW
Practice Address - State:TX
Practice Address - Zip Code:78572-8158
Practice Address - Country:US
Practice Address - Phone:956-583-5837
Practice Address - Fax:956-583-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117668261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care