1962588285 NPI number — CONDADO HOME CARE, 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 1962588285 NPI number — CONDADO HOME CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CONDADO HOME CARE, 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:
1962588285
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
409 CALLE BEGONIA
Provider Second Line Business Mailing Address:
QUINTAS DE CAMPECHE
Provider Business Mailing Address City Name:
CAROLINA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00987-7159
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-607-3943
Provider Business Mailing Address Fax Number:
787-276-5457

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
186 CALLE JUAN P DUARTE
Provider Second Line Business Practice Location Address:
HATO REY
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00917-3602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-758-8180
Provider Business Practice Location Address Fax Number:
787-274-1571
Provider Enumeration Date:
10/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TORRES
Authorized Official First Name:
CARMEN
Authorized Official Middle Name:
LYDIA
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
787-758-8180

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  407011 , 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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