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431 Ave Hostos San Juan PR 00918-3014 | |
| (787) 704-0705 | |
| (787) 744-7444 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 431 Ave Hostos, San Juan, Puerto Rico |
| Authorized Official Name and Position | Javier Enrique Torres (CONTRACTING DEPARTMENT DIRECTOR) |
| Authorized Official Contact | 7877040705 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 9809 Caguas PR 00726-9809 Ph: (787) 704-0705 | 431 Ave Hostos San Juan PR 00918-3014 Ph: (787) 704-0705 |
| NPI Number | 1023516317 |
|---|---|
| Provider Enumeration Date | 02/01/2018 |
| Last Update Date | 02/01/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023516317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | CASM-0237 (Puerto Rico) | Primary |
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