Provider Demographics
NPI:1831234301
Name:PEDIATRIC HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:PEDIATRIC HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IRVIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:VALENTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-789-6712
Mailing Address - Street 1:1502 CALLE BORI
Mailing Address - Street 2:URB ANTONSANTTI
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927
Mailing Address - Country:US
Mailing Address - Phone:787-789-6712
Mailing Address - Fax:787-200-6712
Practice Address - Street 1:1502 CALLE BORI
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-6116
Practice Address - Country:US
Practice Address - Phone:787-789-6712
Practice Address - Fax:787-789-6712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR523140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric