Provider Demographics
NPI:1659732618
Name:HOSPICIO LUZ CELESTE L.L.C.
Entity Type:Organization
Organization Name:HOSPICIO LUZ CELESTE L.L.C.
Other - Org Name:HOSPICIO LUZ CELESTE L.L.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YOLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-249-3433
Mailing Address - Street 1:PO BOX 8427
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726
Mailing Address - Country:US
Mailing Address - Phone:787-249-3433
Mailing Address - Fax:
Practice Address - Street 1:AVE LUIS MUNOZ MARIN H17A
Practice Address - Street 2:VILLA DEL CARMEN
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-6158
Practice Address - Country:US
Practice Address - Phone:787-249-3433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-17
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based