Healthcare Provider Details

I. General information

NPI: 1669924684
Provider Name (Legal Business Name): INSPIRA BEHAVIORAL CARE CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 10/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 CALLE GUADALUPE
PONCE PR
00730-3561
US

IV. Provider business mailing address

PO BOX 9809
CAGUAS PR
00726-9809
UM

V. Phone/Fax

Practice location:
  • Phone: 787-709-4130
  • Fax: 787-744-7444
Mailing address:
  • Phone: 787-709-7130
  • Fax: 787-744-7444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number StatePR

VIII. Authorized Official

Name: DR. ALBERTO M VARELA
Title or Position: PROVEEDORES
Credential: JANELLIE
Phone: 787-704-0705