Provider Demographics
NPI:1942964622
Name:CORTEZ HOUSE INC
Entity Type:Organization
Organization Name:CORTEZ HOUSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELISEO
Authorized Official - Middle Name:TANY
Authorized Official - Last Name:ROJAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-573-9493
Mailing Address - Street 1:438 WHITFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-1601
Mailing Address - Country:US
Mailing Address - Phone:917-573-9493
Mailing Address - Fax:
Practice Address - Street 1:5015 29TH AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-6119
Practice Address - Country:US
Practice Address - Phone:941-795-4025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility