=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184545303
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ECO LIVING SENIOR LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2026
-----------------------------------------------------
Last Update Date | 07/23/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 35 CALLE JUAN C BORBON STE 1093
-----------------------------------------------------
City | GUAYNABO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00969-5374
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-942-2388
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4000 ARCHER DR APT G2 G2
-----------------------------------------------------
City | EAST MOLINE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61244-3947
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-942-2388
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | SANDRA I ROSA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 787-942-2388
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------