Provider Demographics
NPI:1326043407
Name:CORPORACION DE SERVICIOS DE SALUD DE ADJUNTAS INC
Entity Type:Organization
Organization Name:CORPORACION DE SERVICIOS DE SALUD DE ADJUNTAS INC
Other - Org Name:SERVICIOS DE HOSPICIO DE ADJUNTAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:GONZALEZ FIGUEROA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-383-5374
Mailing Address - Street 1:46 CALLE RODULFO GONZALEZ
Mailing Address - Street 2:
Mailing Address - City:ADJUNTAS
Mailing Address - State:PR
Mailing Address - Zip Code:00601-0993
Mailing Address - Country:US
Mailing Address - Phone:787-829-2953
Mailing Address - Fax:787-829-1093
Practice Address - Street 1:46 CALLE RODULFO GONZALEZ
Practice Address - Street 2:
Practice Address - City:ADJUNTAS
Practice Address - State:PR
Practice Address - Zip Code:00601-0993
Practice Address - Country:US
Practice Address - Phone:787-829-2953
Practice Address - Fax:787-829-1093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR401549Medicare ID - Type UnspecifiedHOSPICE