Provider Demographics
NPI:1609491208
Name:HOGAR LAS AGUILAS INCORPORADO
Entity type:Organization
Organization Name:HOGAR LAS AGUILAS INCORPORADO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:EMELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERMUDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-640-1862
Mailing Address - Street 1:1575 PMB 193
Mailing Address - Street 2:AVE MUNOZ RIVERA
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717
Mailing Address - Country:US
Mailing Address - Phone:787-284-6785
Mailing Address - Fax:
Practice Address - Street 1:LA RAMBLA OFFICE PARK
Practice Address - Street 2:621 CARR 14 CALLE MARGINAL
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-284-6785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home