Healthcare Provider Details

I. General information

NPI: 1295713808
Provider Name (Legal Business Name): LUZ DE ESPERANZA HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 03/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BDA FELIX CORDOVA STE 1 (ENTIADOO POR CORREO)
MANATI PR
00674-5400
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: 787-854-7700
  • 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:

# 1
Identifier1063880001
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerPALMETTO

VIII. Authorized Official

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