Provider Demographics
NPI:1669868188
Name:CASA DE SALUD DEL ESTE INC.
Entity type:Organization
Organization Name:CASA DE SALUD DEL ESTE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIARAM
Authorized Official - Middle Name:
Authorized Official - Last Name:AMRUD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-402-8444
Mailing Address - Street 1:PO BOX 1165
Mailing Address - Street 2:
Mailing Address - City:FAJARDO P
Mailing Address - State:PR
Mailing Address - Zip Code:00738-1165
Mailing Address - Country:US
Mailing Address - Phone:787-863-8444
Mailing Address - Fax:787-863-8445
Practice Address - Street 1:URB MONTE VISTA
Practice Address - Street 2:CALLE IGUALDAD LOTE C-2
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-1165
Practice Address - Country:US
Practice Address - Phone:787-863-8444
Practice Address - Fax:787-863-8445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-10
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR#6314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility