Healthcare Provider Details

I. General information

NPI: 1659655488
Provider Name (Legal Business Name): COMPREHENSIVE THERAPEUTIC CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2011
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GJ15 AVE ROBERTO SANCHEZ VILELLA
CAROLINA PR
00982-2656
US

IV. Provider business mailing address

PO BOX 29683
SAN JUAN PR
00929-0683
US

V. Phone/Fax

Practice location:
  • Phone: 787-998-4432
  • Fax: 787-998-4431
Mailing address:
  • Phone: 787-998-4432
  • Fax: 787-998-4431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. AMARILIS SERRANO
Title or Position: PRESIDENT
Credential: PSY.D.
Phone: 787-998-4432