Provider Demographics
NPI:1093836264
Name:SERVICIOS INTEGRADOS DE REHABILITACION DEL OESTE INC.
Entity Type:Organization
Organization Name:SERVICIOS INTEGRADOS DE REHABILITACION DEL OESTE INC.
Other - Org Name:SIRO INC
Other - Org Type:Other Name
Authorized Official - Title/Position:CORPORATE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAISY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:787-849-2179
Mailing Address - Street 1:PO BOX 1302
Mailing Address - Street 2:
Mailing Address - City:HORMIGUEROS
Mailing Address - State:PR
Mailing Address - Zip Code:00660-5302
Mailing Address - Country:US
Mailing Address - Phone:787-849-2179
Mailing Address - Fax:787-849-2205
Practice Address - Street 1:L10 CALLE 4
Practice Address - Street 2:COLINAS DEL OESTE
Practice Address - City:HORMIGUEROS
Practice Address - State:PR
Practice Address - Zip Code:00660-1939
Practice Address - Country:US
Practice Address - Phone:787-849-2179
Practice Address - Fax:787-849-2205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR99-0037-3OtherACAA-SNF
PR=========OtherHUMANA SNF
PR=========OtherMCS SNF
PR=========OtherMCS SNF