Provider Demographics
NPI:1235838277
Name:GRANDMOTHERHOME&CARE INC
Entity Type:Organization
Organization Name:GRANDMOTHERHOME&CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GIOVANNI
Authorized Official - Middle Name:
Authorized Official - Last Name:SALERNO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-979-6747
Mailing Address - Street 1:PO BOX 30347
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-1347
Mailing Address - Country:US
Mailing Address - Phone:787-979-6747
Mailing Address - Fax:
Practice Address - Street 1:URB.MONTE CARLOS 1265
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-2336
Practice Address - Country:US
Practice Address - Phone:787-979-6747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home