Healthcare Provider Details

I. General information

NPI: 1669757126
Provider Name (Legal Business Name): YO ME LEVANTARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2011
Last Update Date: 10/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EL PASEO DE LA COLINA C 25 URB ALTURAS DEL PLATA
CAYEY PR
00737
US

IV. Provider business mailing address

EL PASEO DE LA COLINA C 25 URB ALTURAS DEL PLATA
CAYEY PR
00737
US

V. Phone/Fax

Practice location:
  • Phone: 787-645-5413
  • Fax: 787-746-8079
Mailing address:
  • Phone: 787-223-6949
  • Fax: 787-746-8079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number55762
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number3111
License Number StatePR

VIII. Authorized Official

Name: MR. JESUS RIVERA SR.
Title or Position: PRESIDENTE
Credential: MR
Phone: 787-645-5413