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General NPI Number Information
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NPI Number | 1396415865
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Entity Type | Organization
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Legal Business Name | NEUROACTIVO MEMORY CARE SERVICES LLC.
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Dates
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Enumeration Date | 09/16/2021
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | CARR. #683 KM. 0.1
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City | ARECIBO
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State | PR
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Zip | 00612
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Country | US
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Telephone | 787-689-4245
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Fax |
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Provider Business Mailing Address
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Address Line | 1206 CALLE 62 SE
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City | SAN JUAN
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State | PR
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Zip | 00921-3134
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Country | US
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Telephone | 787-689-4245
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. YAELIS CORAL ACEVEDO
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Credential | MPH-GERO, CDS, PTA
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Telephone | 939-265-8370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number |
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License Number State |
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