Healthcare Provider Details

I. General information

NPI: 1427361732
Provider Name (Legal Business Name): ATENAS COMMUNITY HEALTH CENTER ACHC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2010
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR NUM 2 KM50
MANATI PR
00674
US

IV. Provider business mailing address

PO BOX 455
MANATI PR
00674-0455
US

V. Phone/Fax

Practice location:
  • Phone: 787-854-2292
  • Fax: 787-854-2092
Mailing address:
  • Phone: 787-854-2292
  • Fax: 787-854-2092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number40D0711813
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MISS ZEIMY GOMEZ
Title or Position: DIRECTORA EJECUTIVA
Credential:
Phone: 787-854-2292