Healthcare Provider Details

I. General information

NPI: 1184995557
Provider Name (Legal Business Name): APSHEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2012
Last Update Date: 01/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 91 BOX 9193 HC 91,BUZON 9193
VEGA ALTA PR
00692-9676
US

IV. Provider business mailing address

HC 91 BOX 9193 HC 91,BUZON 9193
VEGA ALTA PR
00692-9676
US

V. Phone/Fax

Practice location:
  • Phone: 939-579-7640
  • Fax: 787-641-0777
Mailing address:
  • Phone: 939-579-7640
  • Fax: 787-641-0777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number104100000X
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StatePR

VIII. Authorized Official

Name: MRS. ANA I. FALCON
Title or Position: SOCIAL WORK
Credential: MSW
Phone: 939-579-7640