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General NPI Number Information
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NPI Number | 1881782753
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Entity Type | Organization
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Legal Business Name | HOSPICIO SAN JUDAS, INC.
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 4836 CALLE LUNA
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City | PONCE
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State | PR
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Zip | 00717-1574
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Country | US
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Telephone | 787-840-8356
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Fax | 787-842-0797
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Provider Business Mailing Address
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Address Line | 4836 CALLE LUNA
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City | PONCE
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State | PR
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Zip | 00717-1574
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Country | US
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Telephone | 787-840-8356
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Fax | 787-842-0797
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. JOSSIE ARLENE FIOL BRUNO
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Credential |
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Telephone | 787-840-8356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 26
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License Number State | PR
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