Provider Demographics
NPI:1770172710
Name:HOGAR KASAMIA 1 CORP
Entity type:Organization
Organization Name:HOGAR KASAMIA 1 CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:YAMIL
Authorized Official - Last Name:MORALES CORA
Authorized Official - Suffix:
Authorized Official - Credentials:ADMIN
Authorized Official - Phone:787-667-2289
Mailing Address - Street 1:M19 CALLE FRONTERA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-2304
Mailing Address - Country:US
Mailing Address - Phone:787-998-4432
Mailing Address - Fax:
Practice Address - Street 1:M19 CALLE FRONTERA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-2304
Practice Address - Country:US
Practice Address - Phone:787-998-4432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No251J00000XAgenciesNursing Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient