Provider Demographics
NPI:1053557355
Name:HOGAR SAN JOSE
Entity type:Organization
Organization Name:HOGAR SAN JOSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR MEDICO
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:F
Authorized Official - Last Name:NOEL IRIZARRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-832-4243
Mailing Address - Street 1:AVENIDA SANTA TERESA JOURNET
Mailing Address - Street 2:
Mailing Address - City:HORMIGUEROS
Mailing Address - State:PR
Mailing Address - Zip Code:00660
Mailing Address - Country:US
Mailing Address - Phone:787-832-4243
Mailing Address - Fax:787-849-1258
Practice Address - Street 1:AVENIDA SANTA TERESA JOURNET
Practice Address - Street 2:
Practice Address - City:HORMIGUEROS
Practice Address - State:PR
Practice Address - Zip Code:00660
Practice Address - Country:US
Practice Address - Phone:787-832-4243
Practice Address - Fax:787-849-1258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-17
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home