Provider Demographics
NPI:1023729266
Name:PROGRAMA DE SERVICIOS DE SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS, INC
Entity type:Organization
Organization Name:PROGRAMA DE SERVICIOS DE SALUD EN EL HOGAR Y HOSPICIO SAN LUCAS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTORE EXECUTIVA OPERACIONAL
Authorized Official - Prefix:MS
Authorized Official - First Name:ISUANET
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-843-4185
Mailing Address - Street 1:PO BOX 7064
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-7064
Mailing Address - Country:US
Mailing Address - Phone:787-843-4185
Mailing Address - Fax:
Practice Address - Street 1:PARKING CENTRO MEDICO PLAZA CENTRAL
Practice Address - Street 2:LOCAL #9 2ND PISO
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00927
Practice Address - Country:US
Practice Address - Phone:787-843-4185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty