Organization
SAN JUAN AGING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEFA COTTO (SUP. DEP DE FACTURACION)
(787) 480-3876
Entity
Organization
Contact information
Practice address
1187 CALLE 46 SE, URBANIZACION REPARTO METROPOLITANO, SAN JUAN, PR 00921-2625
(787) 480-5402
(787) 764-9904
Mailing address
1187 CALLE 46 SE, REPARTO METROPOLITANO, SAN JUAN, PR 00921-2625
(787) 480-5402
(787) 649-9904
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
25487
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25487
NURSE LICENSE
PR
Enumeration date
03/21/2012
Last updated
03/21/2012
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