Healthcare Provider Details

I. General information

NPI: 1538429758
Provider Name (Legal Business Name): CETIF, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2012
Last Update Date: 05/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARRETERA 140 # 15 CATALANA
BARCELONETA PR
00617
US

IV. Provider business mailing address

CARRETERA 140 # 15
BARCELONETA PR
00617
US

V. Phone/Fax

Practice location:
  • Phone: 787-486-4964
  • Fax:
Mailing address:
  • Phone: 787-486-4964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: KATIRIA DIAZ
Title or Position: DIRECTOR
Credential: CLINICAL SOCIAL WORK
Phone: 787-486-4964