Healthcare Provider Details

I. General information

NPI: 1144802885
Provider Name (Legal Business Name): ECS ELDERLY CARE SERVICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 04/22/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 353 KM 1.0 INT CAMINO LOS BORRERO BO. QUEMADO
MAYAGUEZ PR
00680-9426
US

IV. Provider business mailing address

HC 4 BOX 46891
MAYAGUEZ PR
00680-9426
US

V. Phone/Fax

Practice location:
  • Phone: 787-944-6805
  • Fax:
Mailing address:
  • Phone: 787-944-6805
  • 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: NOEMI GONZALEZ LOPEZ
Title or Position: ADMINISTRADORA/ OWNER
Credential:
Phone: 787-944-6805