1982726832 NPI number — THE ADULT DAY ACTIVITY CENTER OF LUBBOCK, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982726832 NPI number — THE ADULT DAY ACTIVITY CENTER OF LUBBOCK, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE ADULT DAY ACTIVITY CENTER OF LUBBOCK, INC.
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:
Provider Other Organization Name Type Code:
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:
1982726832
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2807 42ND STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LUBBOCK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-793-1101
Provider Business Mailing Address Fax Number:
806-793-1150

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2807 42ND STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUBBOCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-793-1101
Provider Business Practice Location Address Fax Number:
806-793-1150
Provider Enumeration Date:
04/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WILLIS
Authorized Official First Name:
CINDY
Authorized Official Middle Name:
KAY
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
806-793-1101

Provider Taxonomy Codes

  • Taxonomy code: 261QA0600X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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