Healthcare Provider Details

I. General information

NPI: 1740223973
Provider Name (Legal Business Name): CONTINUUM MENTAL CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 01/31/2024
Certification Date: 01/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 CALLE DEL CARMEN W
FAJARDO PR
00738
US

IV. Provider business mailing address

55 CALLE DEL CARMEN W
FAJARDO PR
00738
US

V. Phone/Fax

Practice location:
  • Phone: 787-860-3558
  • Fax: 787-860-7066
Mailing address:
  • Phone: 787-860-3558
  • Fax: 787-860-7066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number07B2410
License Number StatePR

VIII. Authorized Official

Name: MRS. IVIA I PACHECO COLLADO
Title or Position: DIRECTOR ADMINISTRATOR
Credential: MBA
Phone: 787-860-3558