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General NPI Number Information
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NPI Number | 1629002316
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Entity Type | Organization
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Legal Business Name | SERVICIOS DE SALUD EN EL HOGAR EL GIGANTE, INC.
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 02/09/2012
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Provider Practice Location Address
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Address Line | 66 CALLE RODULFO GONZALEZ APARTADO 117
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City | ADJUNTAS
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State | PR
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Zip | 00601-2150
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Country | US
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Telephone | 787-829-7710
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Fax | 787-829-4453
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Provider Business Mailing Address
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Address Line | 580 AVE DE DIEGO PUERTO NUEVO
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City | SAN JUAN
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State | PR
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Zip | 00920-3723
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Country | US
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Telephone | 787-620-5577
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Fax | 787-620-5582
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Authorized Official
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Title or Position | CEO
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Name | CARMEN SANTIAGO
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Credential | DRPH
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Telephone | 817-310-1100
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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 | 17810
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License Number State | PR
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