Healthcare Provider Details

I. General information

NPI: 1851115778
Provider Name (Legal Business Name): LE BIEN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2024
Last Update Date: 11/08/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 417 KM 05 BO PIEDRAS BLANCA DESVIO SUR
AGUADA PR
00602-2692
US

IV. Provider business mailing address

B3 URB SAN CRISTOBAL
AGUADA PR
00602-2692
US

V. Phone/Fax

Practice location:
  • Phone: 939-372-4460
  • Fax:
Mailing address:
  • Phone: 939-372-4460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. DANA L CASTRO-HERMIDA
Title or Position: PSYCHOLOGIST
Credential: DRA.
Phone: 939-372-4460