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General NPI Number Information
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NPI Number | 1417256231
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Entity Type | Organization
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Legal Business Name | CAYEY COMMUNITY HEALTH CLINIC
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Dates
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Enumeration Date | 03/18/2011
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Last Update Date | 04/05/2011
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Provider Practice Location Address
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Address Line | CALLE LUIS BARRERAS #10
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City | CAYEY
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State | PR
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Zip | 00736-0000
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Country | US
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Telephone | 787-316-2875
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4985 PMB 103
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City | CAGUAS
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State | PR
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Zip | 00726-4985
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Country | US
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Telephone | 787-316-2875
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JOSE M NIEVES
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Credential |
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Telephone | 787-316-2875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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