Provider Demographics
NPI: | 1992428171 |
---|---|
Name: | SAND COMPREHENSIVE CARE AND REHABILITATION CENTER LLC |
Entity type: | Organization |
Organization Name: | SAND COMPREHENSIVE CARE AND REHABILITATION CENTER LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRIMARY OFFICIAL |
Authorized Official - Prefix: | |
Authorized Official - First Name: | GALDYS |
Authorized Official - Middle Name: | TERESA |
Authorized Official - Last Name: | NIEVES VAZAQUEZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | ING |
Authorized Official - Phone: | 787-636-9537 |
Mailing Address - Street 1: | PO BOX 361192 |
Mailing Address - Street 2: | |
Mailing Address - City: | SAN JUAN |
Mailing Address - State: | PR |
Mailing Address - Zip Code: | 00936-1192 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | CONDOMINIO BALMORAL 1-A TO 1-P |
Practice Address - Street 2: | CALLE DEL PARQUE 110 |
Practice Address - City: | SAN JUAN |
Practice Address - State: | PR |
Practice Address - Zip Code: | 00936 |
Practice Address - Country: | US |
Practice Address - Phone: | 787-636-9537 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-09-22 |
Last Update Date: | 2022-09-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
No | 133N00000X | Dietary & Nutritional Service Providers | Nutritionist | Group - Multi-Specialty | |
No | 171400000X | Other Service Providers | Health & Wellness Coach | Group - Multi-Specialty | |
No | 175F00000X | Other Service Providers | Naturopath | Group - Multi-Specialty | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty | |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
No | 225C00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Counselor | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program | Group - Multi-Specialty |