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General NPI Number Information
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NPI Number | 1730814054
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Entity Type | Organization
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Legal Business Name | PROGRAMA DE SERVICIOS DE SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS, INC
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Dates
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Enumeration Date | 07/20/2022
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Last Update Date | 07/25/2022
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Provider Practice Location Address
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Address Line | CARR 111, KM 3.4 (AVENIDA LOS PATRIOTAS)
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City | LARES
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State | PR
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Zip | 00669-1477
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Country | US
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Telephone | 787-897-0444
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Fax | 787-897-0450
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Provider Business Mailing Address
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Address Line | PO BOX 7064
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City | PONCE
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State | PR
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Zip | 00732-7064
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Country | US
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Telephone | 787-897-0444
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Fax | 787-897-0450
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Authorized Official
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Title or Position | DIRECTORA EJECUTIVA OPERACIONAL
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Name | MR. ISUANET CASTILLO MEDINA
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Credential | CPA
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Telephone | 787-843-4185
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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 |
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License Number State |
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