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General NPI Number Information
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NPI Number | 1427502954
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Entity Type | Organization
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Legal Business Name | LIFE AS A GIFT
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Dates
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Enumeration Date | 08/13/2016
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Last Update Date | 08/13/2016
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Provider Practice Location Address
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Address Line | O13 CALLE LOS PINOS URB SIERRA LINDA
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City | CABO ROJO
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State | PR
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Zip | 00623-3260
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Country | US
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Telephone | 787-463-1294
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Fax |
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Provider Business Mailing Address
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Address Line | O13 CALLE LOS PINOS
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City | CABO ROJO
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State | PR
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Zip | 00623-3260
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Country | US
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Telephone | 787-463-1294
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Fax |
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Authorized Official
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Title or Position | CLINIC SOCIAL WORK
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Name | MRS. MARISOL GONZALEZ SANTANA
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Credential | MWS
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Telephone | 787-463-1294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 11820
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License Number State | PR
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