Provider Demographics
NPI:1902167703
Name:NUEVA VIDA DE LA SALUD HOME CARE CORP
Entity Type:Organization
Organization Name:NUEVA VIDA DE LA SALUD HOME CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-620-2900
Mailing Address - Street 1:PO BOX 3569
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-3569
Mailing Address - Country:US
Mailing Address - Phone:787-915-5748
Mailing Address - Fax:787-915-5814
Practice Address - Street 1:CARR # 2 - KM 15.5, SUITE 7
Practice Address - Street 2:HATO TEJAS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-6107
Practice Address - Country:US
Practice Address - Phone:787-915-5748
Practice Address - Fax:787-915-5814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-07
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
PR37251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health