Provider Demographics
NPI:1093434136
Name:SAN LUCAS METRO, INC
Entity Type:Organization
Organization Name:SAN LUCAS METRO, INC
Other - Org Name:CENTRO DE CUIDADO PROLONGADO SAN LUCAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL FINANCE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA CRUZ SEVERINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-864-4300
Mailing Address - Street 1:RR 9 BOX 6000
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9816
Mailing Address - Country:US
Mailing Address - Phone:787-761-8383
Mailing Address - Fax:
Practice Address - Street 1:CARR 844, KM .5
Practice Address - Street 2:CUPEY
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00928-4153
Practice Address - Country:US
Practice Address - Phone:787-761-8383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-23
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility