Extreme Activities Inc

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

119208 Issued in TX

Legal business name

EXTREME ACTIVITIES INC

Practice address

504 Vitela St
Del Rio, TX 78840

Phone

(830) 775-2552

NPI assigned

Jan 2, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Saul Fernandez Jr.

Title

Director

Phone

(830) 773-2552

Specialties & licenses 1

Addresses

Other names 1

• Willow Creek Adult Day Care Doing business as

Tax ID family

Extreme Activities Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Extreme Activities Inc

  • Adult Day Care Clinic/Center
  • Eagle Pass, TX
  • NPI 1235295494
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013074756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2321 HILLCREST BLVD",
            "address_2": "PO BOX 7100",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788524401",
            "telephone_number": "830-773-2552",
            "fax_number": "830-757-2962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 VITELA ST",
            "city": "DEL RIO",
            "state": "TX",
            "postal_code": "78840",
            "telephone_number": "830-775-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTREME ACTIVITIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "SAUL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "830-773-2552",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "TX",
            "license": "119208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willow Creek Adult Day Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Monica Rodriguez Escobedo, MSN, APRN, FNP-C
• Ricardo Montalvo Espinoza, LPC
• Amanda Leigh Evans, BCBA
• Selina Evans, APRN/ANP
• Valeria Evia, RDN, LD
• Eyemart Express LLC
• Cesar H Faz, M.D.
• Monica P Fernandez
• Rebecca Tarango Fernandez, APRN, FNP-C
• Armando Flores, D.C.

• Adult Day Care Clinic/Center in Del Rio, TX
• Providers in Del Rio, TX by specialty
• Adult Day Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.