Provider Demographics
NPI:1124358817
Name:HOGAR DONA ANA, INC
Entity Type:Organization
Organization Name:HOGAR DONA ANA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MABEL
Authorized Official - Middle Name:MIRANDA
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-642-2037
Mailing Address - Street 1:LEVITTOWN LAKES
Mailing Address - Street 2:FF5 JOSE DE DIEGO 6TA. SECCION
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:787-642-2037
Mailing Address - Fax:
Practice Address - Street 1:LEVITTOWN LAKES
Practice Address - Street 2:FF5 JOSE DE DIEGO 6TA SECCION
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-0000
Practice Address - Country:US
Practice Address - Phone:787-642-2037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR309311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home