Healthcare Provider Details

I. General information

NPI: 1912531013
Provider Name (Legal Business Name): HOGAR REMANSO DE PAZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2020
Last Update Date: 02/28/2020
Certification Date: 02/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO CARICABOA CARR 144 KM 0 H 0.5 INT
JAYUYA PR
00664
US

IV. Provider business mailing address

HC 1 BOX 2000
JAYUYA PR
00664-9701
US

V. Phone/Fax

Practice location:
  • Phone: 787-358-9781
  • Fax:
Mailing address:
  • Phone: 787-358-9781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: YOLANDA SEPULVEDA
Title or Position: OWNER
Credential:
Phone: 787-358-9781