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General NPI Number Information
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NPI Number | 1518032416
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Entity Type | Organization
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Legal Business Name | PUERTO RICAN HOME ATTENDANTS SERVICES, INC
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Dates
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Enumeration Date | 11/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 564 SOUTHERN BLVD FL 2
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City | BRONX
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State | NY
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Zip | 10455-3715
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Country | US
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Telephone | 718-292-8770
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Fax | 718-585-2114
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Provider Business Mailing Address
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Address Line | 564 SOUTHERN BLVD FL 2
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City | BRONX
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State | NY
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Zip | 10455-3715
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Country | US
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Telephone | 718-292-8770
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Fax | 718-585-2114
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. JUAN HERNANDEZ
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Credential |
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Telephone | 718-292-8770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 9911L001
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License Number State | NY
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