Healthcare Provider Details

I. General information

NPI: 1669679015
Provider Name (Legal Business Name): CAREGIVERS DE PUERTO RICO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 CALLE SAN JORGE
SAN JUAN PR
00912-3313
US

IV. Provider business mailing address

409 CALLE SAN JORGE
SAN JUAN PR
00912-3313
US

V. Phone/Fax

Practice location:
  • Phone: 787-726-2272
  • Fax: 787-982-5960
Mailing address:
  • Phone: 787-726-2272
  • Fax: 787-982-5960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State

VIII. Authorized Official

Name: GLENN D PATRON
Title or Position: PRES
Credential:
Phone: 787-726-2272