Hogar Luz de Vida Inc

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

0348 Issued in PR

Legal business name

HOGAR LUZ DE VIDA INC

Practice address

Carr 108 KM 10.9 Ramal 4430 Interior
Bo Lequisamo
Mayaguez, PR 00681

Phone

(787) 833-1508

NPI assigned

Jan 12, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Walter Orlando Perez-Rodriguez

Title

Executive Director

Phone

(787) 410-0781

Specialties & licenses 1

Addresses

Other names 1

• Hogar Luz de Vida Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484179200000",
    "number": "1083150262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 219",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006810219",
            "telephone_number": "787-833-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 108 KM 10.9 RAMAL 4430 INTERIOR",
            "address_2": "BO LEQUISAMO",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00681",
            "telephone_number": "787-833-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOGAR LUZ DE VIDA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-12",
        "last_updated": "2017-01-12",
        "status": "A",
        "authorized_official_last_name": "PEREZ-RODRIGUEZ",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "ORLANDO",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "787-410-0781",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "PR",
            "license": "0348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hogar Luz de Vida",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in Mayaguez, PR
• Providers in Mayaguez, PR by specialty
• Substance Abuse Rehabilitation Facility in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.