| Cdtmayaguez | |
|
452 Ave Ponce De Leon San Juan PR 00918-3490 | |
| (787) 763-5560 | |
| (787) 767-6600 |
| Full Name | Cdtmayaguez |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 452 Ave Ponce De Leon, San Juan, Puerto Rico |
| Authorized Official Name and Position | Antonia Andino Rivera (CDT ADMINISTRATOR) |
| Authorized Official Contact | 7877635560 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cdtmayaguez 452 Ave Ponce De Leon San Juan PR 00918-3490 Ph: (787) 763-5560 | Cdtmayaguez 452 Ave Ponce De Leon San Juan PR 00918-3490 Ph: (787) 763-5560 |
| NPI Number | 1609280072 |
|---|---|
| Provider Enumeration Date | 06/13/2014 |
| Last Update Date | 06/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609280072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 134 (Puerto Rico) | Primary |
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