Healthcare Provider Details

I. General information

NPI: 1598478042
Provider Name (Legal Business Name): DE LA MANO NURSING HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2022
Last Update Date: 01/03/2023
Certification Date: 01/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 101 KM. 1.8 BO. ANCONES
SAN GERMAN PR
00683
US

IV. Provider business mailing address

603 VILLA LOS TORRES
CABO ROJO PR
00623-4358
US

V. Phone/Fax

Practice location:
  • Phone: 787-930-6211
  • Fax:
Mailing address:
  • Phone: 787-930-6211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SHABELLY M RIVERA
Title or Position: PRESIDENT
Credential:
Phone: 787-930-6211