Healthcare Provider Details
I. General information
NPI: 1538077995
Provider Name (Legal Business Name): SOCIAL SUPPORT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
URBANIZACION PORTAL CALLE REINA CASA 87 CALLE 6
SANTA ISABEL PR
00757
US
IV. Provider business mailing address
URBANIZACION PORTAL CALLE REINA CASA 87 CALLE 6
SANTA ISABEL PR
00757
US
V. Phone/Fax
- Phone: 787-533-4510
- Fax:
- Phone: 787-533-4510
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAYANE
M
PADILLA ANDUJAR
Title or Position: PRESIDENT
Credential:
Phone: 787-533-4510