Fuente de Juventud, Inc.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

FUENTE DE JUVENTUD, INC.

Practice address

1138 E Expressway 83
Suite E
Pharr, TX 78577-6518

Phone

(956) 702-3323

Fax

(956) 702-3324

NPI assigned

May 4, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Sonia Gallegos, BS. MPH

Title

Director Owner

Phone

(956) 702-3323

Specialties & licenses 1

Addresses

Tax ID family

Fuente de Juventud 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.

• Fuente de Juventud, Inc.

  • Adult Day Care Clinic/Center
  • Donna, TX
  • NPI 1306583117
  NPD tax ID

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376755140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 E EXPRESSWAY 83",
            "address_2": "SUITE E",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785776518",
            "telephone_number": "956-702-3323",
            "fax_number": "956-702-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 E EXPRESSWAY 83",
            "address_2": "SUITE E",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785776518",
            "telephone_number": "956-702-3323",
            "fax_number": "956-702-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUENTE DE JUVENTUD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GALLEGOS",
        "authorized_official_first_name": "SONIA",
        "authorized_official_title_or_position": "DIRECTOR OWNER",
        "authorized_official_telephone_number": "956-702-3323",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "BS. MPH"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marco Tulio Florez, MD
• Fly Away Therapy Corp
• Hephzibah Beulah Forsac
• Jennifer Frantz, OT
• Frontier Direct Care Pharr
• Abel Fuentes Jr., MSN, APRN, FNP-BC
• Functional Gainz Therapeutics, LLC
• Mallory Funk, MSW
• Amanda Diane Garcia, OTR
• Antonio T Garcia, NP

• Adult Day Care Clinic/Center in Pharr, TX
• Providers in Pharr, 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.