Provider Demographics
NPI:1114592177
Name:SAN MARTIN CARE LLC
Entity Type:Organization
Organization Name:SAN MARTIN CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:JR
Authorized Official - Last Name:SAN MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-462-9224
Mailing Address - Street 1:51 JEFFERSON LN
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06118-2149
Mailing Address - Country:US
Mailing Address - Phone:860-462-9224
Mailing Address - Fax:
Practice Address - Street 1:51 JEFFERSON LN
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06118-2149
Practice Address - Country:US
Practice Address - Phone:860-462-9224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-23
Last Update Date:2021-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care