Provider Demographics
NPI:1194919308
Name:PUERTO RICO CARE RESPONSE HOME HEALTH AGENCY CORP.
Entity type:Organization
Organization Name:PUERTO RICO CARE RESPONSE HOME HEALTH AGENCY CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOTAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-644-4560
Mailing Address - Street 1:AVE. LAS AMERICAS
Mailing Address - Street 2:URB. CONSTANCIA # 2644-A
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717
Mailing Address - Country:US
Mailing Address - Phone:787-290-2351
Mailing Address - Fax:787-290-2352
Practice Address - Street 1:AVE. LAS AMERICAS
Practice Address - Street 2:URB. CONSTANCIA # 2644-A
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-290-2351
Practice Address - Fax:787-290-2352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health