Healthcare Provider Details

I. General information

NPI: 1548084635
Provider Name (Legal Business Name): INSPIRA BEHAVIORAL CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2024
Last Update Date: 11/14/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 EDF. A. PORRATA PILA 2431 BLVD. LUIS A. FERRE
PONCE PR
00717
US

IV. Provider business mailing address

PO BOX 9809
CAGUAS PR
00726-9809
US

V. Phone/Fax

Practice location:
  • Phone: 787-704-0705
  • Fax: 787-744-7444
Mailing address:
  • Phone: 787-704-0705
  • Fax: 787-744-7444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAMELA MARTINEZ
Title or Position: PROVIDERS DEPARTMENT
Credential: MSW
Phone: 787-704-0705