Healthcare Provider Details

I. General information

NPI: 1205350576
Provider Name (Legal Business Name): LUZ DE ESPERANZA HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2017
Last Update Date: 07/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 BDA FELIX CORDOVA DAVILA
MANATI PR
00674-5952
US

IV. Provider business mailing address

PO BOX 3446
MANATI PR
00674-3446
US

V. Phone/Fax

Practice location:
  • Phone: 787-854-7700
  • 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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MANUEL SANTIAGO
Title or Position: CEO
Credential:
Phone: 787-854-7700