Provider Demographics
NPI:1881016020
Name:COMMUNITY HEALTH FOUNDATION OF PUERTO RICO, INC.
Entity Type:Organization
Organization Name:COMMUNITY HEALTH FOUNDATION OF PUERTO RICO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:787-780-1273
Mailing Address - Street 1:MARGINAL SANTA CRUZ C-17
Mailing Address - Street 2:URB. SANTA CRUZ
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-523-3113
Mailing Address - Fax:787-995-0851
Practice Address - Street 1:MARGINAL SANTA CRUZ C-17
Practice Address - Street 2:URB. SANTA CRUZ
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-523-3113
Practice Address - Fax:787-995-0851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-07
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)