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General NPI Number Information
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NPI Number | 1114647849
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Entity Type | Organization
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Legal Business Name | CENTRO DE INTEGRACION DESARROLLO Y AYUDA AL NINO ADULTO E INFANTE LLC
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Dates
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Enumeration Date | 09/01/2022
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | CARR. 2 KM 122.5 BO. CAIMITAL ALTO
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City | AGUADILLA
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State | PR
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Zip | 00603
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Country | US
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Telephone | 939-313-0343
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Fax |
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Provider Business Mailing Address
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Address Line | 3623 AVE MILITAR SUITE 101 PMB 311
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City | ISABELA
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State | PR
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Zip | 00662
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Country | US
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Telephone | 939-313-0343
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Fax |
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Authorized Official
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Title or Position | PATOLOGA DEL HABLA Y LENGUAJE
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Name | MARA ITZEL SOTO
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Credential | LCDA
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Telephone | 939-275-0591
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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