Organization
SAN JUAN HEART, LLC
Active
Other names
Saint John
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN DE LA CRUZ (CEO)
(973) 458-8292
Entity
Organization
Contact information
Practice address
625 MAIN AVE, PASSAIC, NJ 07055-4952
(973) 458-8292
(973) 777-1637
Mailing address
39 AYCRIGG AVE, PASSAIC, NJ 07055-5664
(973) 458-8292
(973) 777-1637
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HP0046601
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HP0046601
HP
NJ
Enumeration date
08/09/2009
Last updated
08/09/2009
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