Healthcare Provider Details

I. General information

NPI: 1295427409
Provider Name (Legal Business Name): ECO CLEAN PR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2023
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 CALLE DE DIEGO APT 510
SAN JUAN PR
00924-3828
US

IV. Provider business mailing address

575 CALLE DE DIEGO APT 510
SAN JUAN PR
00924-3828
US

V. Phone/Fax

Practice location:
  • Phone: 787-560-3151
  • Fax:
Mailing address:
  • Phone: 787-560-3151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: MRS. SANDRA I. ROSA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 877-560-3151