Organization
ST DOMINICS SENIOR CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMELITA JOSON CINCO NHA (ADMINISTRATOR)
(671) 632-9370
Entity
Organization
Contact information
Practice address
350 NORTH SABANA DRIVE, BARRIGADA HEIGHTS, GU 96913-1262
(671) 632-9370
(671) 637-1679
Mailing address
350 NORTH SABANA DRIVE, BARRIGADA HEIGHTS, GU 96913-1262
(671) 632-9370
(671) 637-1679
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
2007001
GU
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
405
MEDICALLY INDIGENT PROGRA
GU
Enumeration date
12/03/2007
Last updated
12/03/2007
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