Provider Demographics
NPI:1508889825
Name:HOSPICIO SAN FRANCISCO DE ASIS, INC.
Entity Type:Organization
Organization Name:HOSPICIO SAN FRANCISCO DE ASIS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ENNELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:COFRESI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-868-2920
Mailing Address - Street 1:BO GUANIQUILLA CARR 441 KM 4.6
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00602
Mailing Address - Country:UM
Mailing Address - Phone:787-868-2920
Mailing Address - Fax:787-252-3199
Practice Address - Street 1:CARR 441 KM 4.6
Practice Address - Street 2:BO. GUANIQUILLA
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602
Practice Address - Country:US
Practice Address - Phone:787-868-2920
Practice Address - Fax:787-252-0211
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPICIO SAN FRANCISCO DE ASIS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-26
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR401551OtherPTAN