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General NPI Number Information
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NPI Number | 1023011376
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Entity Type | Organization
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Legal Business Name | HOSPICIO LA GUADALUPE INC
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | CARR #14 ANEXO HOSP ONCOLOGICO
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City | PONCE
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State | PR
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Zip | 00732-0000
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Country | US
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Telephone | 787-259-8210
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7699
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City | PONCE
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State | PR
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Zip | 00732-7699
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Country | US
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Telephone | 787-259-8210
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Fax | 787-259-8205
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. LUZ M GONZALEZ
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Credential |
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Telephone | 787-259-8210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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