Healthcare Provider Details

I. General information

NPI: 1609381524
Provider Name (Legal Business Name): INSPIRA BEHAVIORAL CARE CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2017
Last Update Date: 12/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE 2 KM 11.8 EDIFICIO CENTURION PISO 3
BAYAMON PR
00961
US

IV. Provider business mailing address

PO BOX 9809
CAGUAS PR
00726-9809
US

V. Phone/Fax

Practice location:
  • Phone: 787-704-0705
  • Fax: 787-744-7444
Mailing address:
  • Phone: 787-704-0705
  • Fax: 787-744-7444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberCASM-0341
License Number State
# 2
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License NumberHP-0341
License Number StatePR

VIII. Authorized Official

Name: MR. JAVIER ENRIQUE TORRES
Title or Position: CONTRACTING DEPARTMENT DIRECTOR
Credential: MHSA
Phone: 787-704-0705