Healthcare Provider Details

I. General information

NPI: 1003727199
Provider Name (Legal Business Name): HS GENESIS RIVERA DE JESUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. VALLE PARAISO C8, LOS LLANOS
COAMO PR
00769
US

IV. Provider business mailing address

PO BOX 318
VILLALBA PR
00766-0318
US

V. Phone/Fax

Practice location:
  • Phone: 939-243-4884
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GENESIS RIVERA DE JESUS
Title or Position: DIRECTORA
Credential:
Phone: 939-243-4884