Healthcare Provider Details

I. General information

NPI: 1457599102
Provider Name (Legal Business Name): BIEN EN CASA VIDA INDEPENDIENTE EN EL HOGAR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2009
Last Update Date: 12/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1797 CALLE SAN ALEJANDRO
SAN JUAN PR
00927-6347
US

IV. Provider business mailing address

PO BOX 7736
SAN JUAN PR
00916-7736
US

V. Phone/Fax

Practice location:
  • Phone: 787-727-1344
  • Fax: 787-294-8190
Mailing address:
  • Phone: 787-727-1344
  • Fax: 787-294-8190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MS. OLIRIA G RATCLIFFE
Title or Position: PARTNER/GENERAL MANAGER
Credential: M. ED.
Phone: 787-727-1344