Provider Demographics
NPI:1124466602
Name:HOGAR MARIA DE ISABELA, INC
Entity type:Organization
Organization Name:HOGAR MARIA DE ISABELA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTER NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:CALERO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN,MPH
Authorized Official - Phone:787-717-3886
Mailing Address - Street 1:PO BOX 2532
Mailing Address - Street 2:BO .MORA SECTOR JAVILLO
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-9532
Mailing Address - Country:US
Mailing Address - Phone:787-830-8116
Mailing Address - Fax:787-830-8118
Practice Address - Street 1:KM 111.2 AVE MILITAR
Practice Address - Street 2:BO. MORA SECTOR JAVILLO
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-9532
Practice Address - Country:US
Practice Address - Phone:787-830-8116
Practice Address - Fax:787-830-8118
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOGAR MARIA DE ISABELA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-06
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15131163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty