Healthcare Provider Details

I. General information

NPI: 1679965446
Provider Name (Legal Business Name): PARTNERS IN HOPE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2015
Last Update Date: 03/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CALLE MUGUEL UNAMUNO
MAYAGUEZ PR
00682-6637
US

IV. Provider business mailing address

PO BOX 3815
MAYAGUEZ PR
00681-3815
US

V. Phone/Fax

Practice location:
  • Phone: 787-516-8912
  • Fax:
Mailing address:
  • Phone: 787-516-8912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number004745
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number004745
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number004745
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number004745
License Number StatePR

VIII. Authorized Official

Name: DR. JANICE M CRUZ
Title or Position: CLINICAL PSYCHOLOGY
Credential: PHD
Phone: 787-516-8912