Healthcare Provider Details

I. General information

NPI: 1902622558
Provider Name (Legal Business Name): DJC ROCK PROPERTIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2024
Last Update Date: 11/27/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 CALLE MANUEL DOMENECH UNIT 674
SAN JUAN PR
00918-3503
US

IV. Provider business mailing address

116 CALLE MANUEL DOMENECH UNIT 674
SAN JUAN PR
00918-3503
US

V. Phone/Fax

Practice location:
  • Phone: 787-425-4674
  • Fax: 623-321-1633
Mailing address:
  • Phone: 787-425-4674
  • Fax: 623-321-1633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JUDITH CARTER
Title or Position: CO-OWNER
Credential:
Phone: 480-442-7365