Provider Demographics
NPI:1790777266
Name:PROGRAMA DE SERVICIOS DE SALUD EN EL HOGAR DEL NORTE, INC.
Entity Type:Organization
Organization Name:PROGRAMA DE SERVICIOS DE SALUD EN EL HOGAR DEL NORTE, INC.
Other - Org Name:DEL NORTE HOME CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-898-1009
Mailing Address - Street 1:PO BOX 143114
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-3114
Mailing Address - Country:US
Mailing Address - Phone:787-898-1009
Mailing Address - Fax:787-262-8737
Practice Address - Street 1:BO HATO ABAJO SECTOR BARRANCA CARR 653 KM 2.0
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-0000
Practice Address - Country:US
Practice Address - Phone:787-898-1009
Practice Address - Fax:787-262-8737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-19
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR407029251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR407029Medicare Oscar/Certification