Provider Demographics
NPI:1013909712
Name:ST LUKES EPISCOPAL CHURCH HOME CARE PROGRAM
Entity Type:Organization
Organization Name:ST LUKES EPISCOPAL CHURCH HOME CARE PROGRAM
Other - Org Name:ST. LUKES HOME HEALTH AGENCY SALINAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTORA EJECUTIVA
Authorized Official - Prefix:MRS
Authorized Official - First Name:ISUANET
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:787-843-4185
Mailing Address - Street 1:RR1 BOX 6091
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00784-9601
Mailing Address - Country:US
Mailing Address - Phone:787-843-4185
Mailing Address - Fax:787-259-7135
Practice Address - Street 1:SECTOR MELANIA CARR. #3
Practice Address - Street 2:CENTRO COMERCIAL SAN VICENTE MALL
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-9601
Practice Address - Country:US
Practice Address - Phone:787-843-4185
Practice Address - Fax:787-259-7135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR26251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR19485 STOtherST. LUKES HC SALINAS
PR071002OtherST. LUKES HC SALINAS
PR7320125OtherST. LUKES HC SALINAS
PR9800093OtherST. LUKES HC SALINAS
PA733102OtherST. LUKES HC SALINAS
PA733102OtherST. LUKES HC SALINAS
PA733102OtherST. LUKES HC SALINAS