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General NPI Number Information
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NPI Number | 1063362622
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Entity Type | Organization
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Legal Business Name | HEAVEN MENTAL HEALTH CLINIC LLC
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Dates
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Enumeration Date | 02/02/2026
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 125 CALLE FONT MARTELO
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City | HUMACAO
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State | PR
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Zip | 00791-3357
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Country | US
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Telephone | 215-760-9169
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8399
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City | HUMACAO
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State | PR
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Zip | 00792-8399
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE
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Name | DR. MOISES M VALDEZ SANCHEZ
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Credential | MD
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Telephone | 215-760-9169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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