Provider Demographics
NPI:1770748816
Name:MI RANCHITO ADULT DAY CARE LLC
Entity type:Organization
Organization Name:MI RANCHITO ADULT DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTEMAYOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-453-6371
Mailing Address - Street 1:503 E 2ND ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:LA JOYA
Mailing Address - State:TX
Mailing Address - Zip Code:78560-4158
Mailing Address - Country:US
Mailing Address - Phone:956-519-8886
Mailing Address - Fax:956-519-8887
Practice Address - Street 1:503 E 2ND ST UNIT B
Practice Address - Street 2:
Practice Address - City:LA JOYA
Practice Address - State:TX
Practice Address - Zip Code:78560-4158
Practice Address - Country:US
Practice Address - Phone:956-519-8886
Practice Address - Fax:956-519-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care