Healthcare Provider Details
I. General information
NPI: 1801614383
Provider Name (Legal Business Name): APS CLINICS OF PUERTO RICO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/02/2024
Last Update Date: 10/02/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
APS CLINICS OF PUERTO RICO TOA BAJA AVE SABANA SECA, INT 867
TOA BAJA PR
00949
US
IV. Provider business mailing address
PO BOX 71474
SAN JUAN PR
00936-8574
US
V. Phone/Fax
- Phone: 787-641-0774
- Fax:
- Phone: 787-641-0774
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JASON
MORALES
Title or Position: VP REGULATORY AFFAIRS
Credential:
Phone: 787-641-0774