Provider Demographics
NPI:1659314664
Name:SALUD INTEGRAL EN LA MONTANA, INC
Entity Type:Organization
Organization Name:SALUD INTEGRAL EN LA MONTANA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMADOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-869-5900
Mailing Address - Street 1:PO BOX 515
Mailing Address - Street 2:
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719-0515
Mailing Address - Country:US
Mailing Address - Phone:787-857-5800
Mailing Address - Fax:787-857-4483
Practice Address - Street 1:CARR 164, KM 0.2, SECTOR EL DESVIO
Practice Address - Street 2:BO ACHIOTE
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-0515
Practice Address - Country:US
Practice Address - Phone:787-857-5800
Practice Address - Fax:787-857-4483
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SALUD INTEGRAL EN LA MONTANA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-14
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR407008Medicare PIN