Provider Demographics
NPI:1104643725
Name:HOSPICIO VIDA, INC
Entity type:Organization
Organization Name:HOSPICIO VIDA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWN
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:MERCADO CORTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:939-585-5609
Mailing Address - Street 1:ALTURAS DE BEATRIZ 222 CALLE PICAFLOR
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-3023
Mailing Address - Country:US
Mailing Address - Phone:939-585-5609
Mailing Address - Fax:
Practice Address - Street 1:ALTURAS DE BEATRIZ 222 CALLE PICAFLOR
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:939-585-5609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-24
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care