Provider Demographics
NPI:1740223759
Name:DD HOME CARE SAN FRANCISCO DE ASIS INC.
Entity Type:Organization
Organization Name:DD HOME CARE SAN FRANCISCO DE ASIS INC.
Other - Org Name:HOME CARE FRANCISCOS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CONFESOR
Authorized Official - Middle Name:
Authorized Official - Last Name:LASALLE RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-819-4684
Mailing Address - Street 1:P.O. BOX 1538
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678
Mailing Address - Country:US
Mailing Address - Phone:787-819-4684
Mailing Address - Fax:787-882-4660
Practice Address - Street 1:AVE. MILITAR #4930
Practice Address - Street 2:SUITE 1
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-819-4684
Practice Address - Fax:787-882-4660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR49251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR407031Medicare Oscar/Certification