Healthcare Provider Details

I. General information

NPI: 1730495219
Provider Name (Legal Business Name): ABRAZOS TERAPEUTICOS MANAEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2010
Last Update Date: 08/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RD 3 KM 27.0
RIO GRANDE PR
00745
US

IV. Provider business mailing address

PO BOX 1087
CANOVANAS PR
00729-1087
US

V. Phone/Fax

Practice location:
  • Phone: 787-513-2828
  • Fax:
Mailing address:
  • Phone: 787-513-2828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MIGUEL A. TORRES
Title or Position: PRESIDENT
Credential:
Phone: 787-513-2828