Provider Demographics
NPI:1871272856
Name:CASA AZUL ADULT DAY CARE LLC
Entity type:Organization
Organization Name:CASA AZUL ADULT DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CABALLERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-900-8655
Mailing Address - Street 1:7216 N 34TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-0570
Mailing Address - Country:US
Mailing Address - Phone:956-900-8655
Mailing Address - Fax:
Practice Address - Street 1:2109 W MILE 3 RD
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78573-5073
Practice Address - Country:US
Practice Address - Phone:956-271-4315
Practice Address - Fax:956-338-5608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care