Organization
FAJARDO HOME CARE PROGRAM, INC.
Active
Other names
CUIDADO CASERO FAJARDO
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEN SANTIAGO DRPH (CEO)
(817) 310-1100
Entity
Organization
Contact information
Practice address
375 AVE GENERAL VALERO, SUITE 109, FAJARDO, PR 00738-4893
(787) 868-6361
(787) 850-5270
Mailing address
1110 N CARROLL AVE, SOUTHLAKE, TX 76092-5306
(817) 310-1100
(817) 310-1197
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
11621
PR
Other
Enumeration date
07/12/2006
Last updated
09/11/2009
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