Healthcare Provider Details

I. General information

NPI: 1669469383
Provider Name (Legal Business Name): RCA PSYCHOTHERAPEUTIC GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

848 KM 30 BO SAN ANTON
CAROLINA PR
00983
US

IV. Provider business mailing address

PO BOX 8700
CAROLINA PR
00988-8700
US

V. Phone/Fax

Practice location:
  • Phone: 787-276-0400
  • Fax: 787-276-0210
Mailing address:
  • Phone: 787-276-0400
  • Fax: 787-276-0210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: ARMANDA RIVERA CABALLERO
Title or Position: PRESIDENT
Credential:
Phone: 787-276-0400