Provider Demographics
NPI:1053600270
Name:HOGAR LLEVANDO LUZ A LAS TINIEBLAS, INC.
Entity type:Organization
Organization Name:HOGAR LLEVANDO LUZ A LAS TINIEBLAS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADDICTION COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIJOS
Authorized Official - Suffix:
Authorized Official - Credentials:ADC
Authorized Official - Phone:787-378-4221
Mailing Address - Street 1:CALLE VIA PELICANO CK-9505
Mailing Address - Street 2:URB. CAMINO DEL MAR
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-0000
Mailing Address - Country:US
Mailing Address - Phone:787-732-2323
Mailing Address - Fax:
Practice Address - Street 1:PR 782 KM.9 HM.7 BARRIO BAYAMONCITO
Practice Address - Street 2:SECTOR EL PUNTO
Practice Address - City:AGUAS BUENAS
Practice Address - State:PR
Practice Address - Zip Code:00703
Practice Address - Country:US
Practice Address - Phone:787-732-2323
Practice Address - Fax:787-732-2525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0589261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder