| NPI | 1750983375 |
|---|---|
| Former Legal Business Name | CLUB DE ACTIVIDADES SU CASA |
| Entity Type | Organization |
| Authorized Contact | AIDA VARGAS Owner 915-256-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2020-11-09 |
| Last Update Date | 2023-02-24 |