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General NPI Number Information
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NPI Number | 1841273224
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Entity Type | Organization
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Legal Business Name | COMPLEJO MEDICO SOCIAL HOME CARE
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 06/18/2009
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Provider Practice Location Address
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Address Line | AVE. 65TH INFANTERIA BO. SABANA LLANA
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City | SAN JUAN
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State | PR
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Zip | 00929
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Country | US
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Telephone | 787-764-9124
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Fax | 787-764-9904
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Provider Business Mailing Address
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Address Line | AVE. 65TH INFANTERIA BO. SABANA LLANA PO BOX 29395
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City | SAN JUAN
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State | PR
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Zip | 00929
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Country | US
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Telephone | 787-764-9124
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Fax | 787-764-9904
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. MARITZA VEGA
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Credential | RN,BSN,MSN,MBA/HCM
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Telephone | 787-764-9124
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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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