Healthcare Provider Details

I. General information

NPI: 1407162662
Provider Name (Legal Business Name): WCHM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2010
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8269 AVE JOBOS
ISABELA PR
00662-2227
US

IV. Provider business mailing address

8269 AVE JOBOS
ISABELA PR
00662-2227
US

V. Phone/Fax

Practice location:
  • Phone: 787-872-2113
  • Fax: 787-830-7839
Mailing address:
  • Phone: 787-872-2113
  • Fax: 787-830-7839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CARLOS E GUEVARA
Title or Position: PRESIDENT
Credential:
Phone: 787-872-2113