Healthcare Provider Details

I. General information

NPI: 1689874364
Provider Name (Legal Business Name): HOGAR XELAY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 07/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RD 861 KM 2.0 BO. PAJAROS
BAYAMON PR
00956
US

IV. Provider business mailing address

500 PASEO MONACO APTO 17 EDIF 9
BAYAMON PR
00956-9773
US

V. Phone/Fax

Practice location:
  • Phone: 787-797-1980
  • Fax: 787-797-1980
Mailing address:
  • Phone: 787-797-1980
  • Fax: 787-797-1980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number262
License Number StatePR

VIII. Authorized Official

Name: MRS. NANCY SANCHEZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 787-797-1980