Provider Demographics
NPI:1487810479
Name:HOGAR SAN GERMAN DE AUXERRE, INC
Entity type:Organization
Organization Name:HOGAR SAN GERMAN DE AUXERRE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-892-5841
Mailing Address - Street 1:10 CALLE AZORIN
Mailing Address - Street 2:BO ANCONES
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-4242
Mailing Address - Country:US
Mailing Address - Phone:787-892-5841
Mailing Address - Fax:787-892-4332
Practice Address - Street 1:10 CALLE AZORIN
Practice Address - Street 2:BO ANCONES
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4242
Practice Address - Country:US
Practice Address - Phone:787-892-5841
Practice Address - Fax:787-892-4332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR85311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home