Provider Demographics
NPI:1396501698
Name:HOGAR MI DULCE ESTANCIA LLC
Entity type:Organization
Organization Name:HOGAR MI DULCE ESTANCIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:RIOS ROLDAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-448-8497
Mailing Address - Street 1:SEA VIEW SUITES
Mailing Address - Street 2:2483 PLAYUELA APT #18
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603
Mailing Address - Country:US
Mailing Address - Phone:787-448-8497
Mailing Address - Fax:
Practice Address - Street 1:CARR 472 KM 1.0 CALLE
Practice Address - Street 2:CASIMIRO DE CASTRO #132 BO BEJUCOS
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-448-8497
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-23
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility