Organization
SAN JUAN AGING CENTER
Active
Other names
Social Medical Complex Antillas
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARITZA VEGA MBA/HCM (EXECUTIVE DIRECTOR)
(787) 764-9124
Entity
Organization
Contact information
Practice address
AVE. 65 INFANTERY BO. SABANA LLANA, SAN JUAN, PR 00929
(787) 764-9124
(787) 764-9904
Mailing address
PO BOX 29395, SAN JUAN, PR 00929-0395
(787) 764-9124
(787) 764-9904
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001365
AMERICAN HEALTH
PR
01
—
2501325
ACCA
PR
01
—
40081
PREFERRED MEDICARE CHOICE
PR
01
—
4500121
ACCA
PR
01
—
68650-41041
CRUZ AZUL
PR
01
—
820953
MMM
PR
01
—
9900144
ACCA
PR
01
—
P113
FIRST MEDICAL
PR
Enumeration date
11/09/2005
Last updated
08/22/2020
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