Healthcare Provider Details

I. General information

NPI: 1134115587
Provider Name (Legal Business Name): HOSPITAL DE PQUIATRIA FORENSE DE RIO PIEDRAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE CENTRO MEDICO AVE JOSE KIKO CUSTODIO
SAN JUAN PR
00927
US

IV. Provider business mailing address

PO BOX 2100
SAN JUAN PR
00922-2100
US

V. Phone/Fax

Practice location:
  • Phone: 787-766-4646
  • Fax:
Mailing address:
  • Phone: 787-766-4646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number3
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number3
License Number StatePR

VIII. Authorized Official

Name: EVELYN TORRES IRIZARRY
Title or Position: DIRECTOR
Credential:
Phone: 787-766-4646