Provider Demographics
NPI:1457806895
Name:AMADA HEALTH CARE
Entity Type:Organization
Organization Name:AMADA HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROXANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-923-1321
Mailing Address - Street 1:209 CIRCULO C
Mailing Address - Street 2:BASE RAMEY
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-1246
Mailing Address - Country:US
Mailing Address - Phone:787-868-0906
Mailing Address - Fax:787-868-0906
Practice Address - Street 1:CARR 2 KM 137.8
Practice Address - Street 2:BARRIO CERRO GORDO
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602
Practice Address - Country:US
Practice Address - Phone:787-868-0906
Practice Address - Fax:787-868-0906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-15
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility