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General NPI Number Information
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NPI Number | 1124776158
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Entity Type | Organization
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Legal Business Name | SERVICIOS INTEGRALES DE SALUD EMOCIONAL SISE CSP
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Dates
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Enumeration Date | 03/18/2022
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | CARR. 155 KM 55.9 BO FRANQUEZ
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City | MOROVIS
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State | PR
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Zip | 00687
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Country | US
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Telephone | 939-276-2432
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Fax |
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Provider Business Mailing Address
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Address Line | HC 01 BOX 2381
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City | MOROVIS
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State | PR
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Zip | 00687-8251
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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 | PRESIDENT
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Name | LYDIA Z RODRIGUEZ RIOS
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Credential |
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Telephone | 939-276-2432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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