Healthcare Provider Details

I. General information

NPI: 1114626991
Provider Name (Legal Business Name): COMMUNITY HEALTH FOUNDATION OF PUERTO RICO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2023
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 2 MARGINAL SANTA CRUZ ESQUINA ESTEBAN PADILLA
BAYAMON PR
00961
US

IV. Provider business mailing address

MARGINAL SANTA CRUZ C-17 URB. SANTA CRUZ
BAYAMON PR
00961
US

V. Phone/Fax

Practice location:
  • Phone: 787-523-3113
  • Fax:
Mailing address:
  • Phone:
  • 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
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ALBERTO LOPEZ TORO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 787-780-1273