1053600270 NPI number — HOGAR LLEVANDO LUZ A LAS TINIEBLAS, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053600270 NPI number — HOGAR LLEVANDO LUZ A LAS TINIEBLAS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOGAR LLEVANDO LUZ A LAS TINIEBLAS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053600270
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/29/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CALLE VIA PELICANO CK-9505
Provider Second Line Business Mailing Address:
URB. CAMINO DEL MAR
Provider Business Mailing Address City Name:
TOA BAJA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00949-0000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-732-2323
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PR 782 KM.9 HM.7 BARRIO BAYAMONCITO
Provider Second Line Business Practice Location Address:
SECTOR EL PUNTO
Provider Business Practice Location Address City Name:
AGUAS BUENAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-732-2323
Provider Business Practice Location Address Fax Number:
787-732-2525
Provider Enumeration Date:
03/29/2011

Additional Information

Authorized Official

Authorized Official Last Name:
RIJOS
Authorized Official First Name:
ARMANDO
Authorized Official Middle Name:
Authorized Official Title or Position:
ADDICTION COUNSELOR
Authorized Official Telephone Number:
787-378-4221

Provider Taxonomy Codes

  • Taxonomy code: 261QR0405X , with the licence number:  0589 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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