Fuente de Juventud, Inc.

Organization Active NPI Adult Day Care Clinic/Center · Donna, TX

NPI 1306583117 · NPPES record last updated May 14, 2022

Key facts

NPI
1306583117
Entity type
Organization (NPI type 2)
Primary specialty
Adult Day Care Clinic/Center 261QA0600X
Legal business name
FUENTE DE JUVENTUD, INC.
Practice address
2008 Redskin Ave Ste a
Donna, TX 78537-3299
Phone
(956) 377-5158
Fax
(956) 377-5204
NPI assigned
May 14, 2022
Organization subpart
No

Authorized official

Name
Sonia Gallegos, MPH
Title
Administrator
Phone
(956) 702-3323

Corporate family (same tax ID) 1

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

National Provider Directory

Tax ID family
Fuente de Juventud Inc (2 organizations share this tax ID)

Locations

2008 Redskin Ave
#A
Donna, TX 78537
Phone (956) 377-5158

1138 E Interstate 2
Ste E
Pharr, TX 78577

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X Yes

Addresses

Primary practice location

2008 Redskin Ave Ste a
Donna, TX 78537-3299

Mailing address

1138 E Interstate 2 Ste E
Pharr, TX 78577-6519
Phone (956) 702-3323

Other identifiers

IdentifierTypeStateIssuer
8007326201MedicaidTX

Other providers in Donna, TX

All providers in Donna, TX · Adult Day Care Clinic/Center in Texas

Sources for this page

Verify at the official NPI Registry.