Provider Demographics
NPI:1316281256
Name:DOMICILIARY CARE ORGANIZATION OF PUERTO RICO
Entity type:Organization
Organization Name:DOMICILIARY CARE ORGANIZATION OF PUERTO RICO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:LOPEZ ROCAFORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-743-0525
Mailing Address - Street 1:49 CALLE MUNOZ RIVERA
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-3112
Mailing Address - Country:US
Mailing Address - Phone:787-743-0525
Mailing Address - Fax:
Practice Address - Street 1:49 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777-3112
Practice Address - Country:US
Practice Address - Phone:787-743-0525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty