1497919260 NPI number — PROMISES TO KEEP, LLC

Table of content: (NPI 1497919260)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497919260 NPI number — PROMISES TO KEEP, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PROMISES TO KEEP, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
A PROMISES KEPT ADULT ACTIVITIES CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497919260
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4020 N 22ND ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCALLEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78504-4101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-972-1414
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
420 S CLOSNER BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDINBURG
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78539-4563
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-383-8222
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/10/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PEREZ-RODRIGUEZ
Authorized Official First Name:
DELLA
Authorized Official Middle Name:
FAY
Authorized Official Title or Position:
VICE-PRESIDENT
Authorized Official Telephone Number:
956-972-1414

Provider Taxonomy Codes

  • Taxonomy code: 311ZA0620X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)