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General NPI Number Information
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NPI Number | 1467742650
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Entity Type | Organization
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Legal Business Name | INSPIRA BEHAVIORAL CARE
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Dates
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Enumeration Date | 04/09/2011
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Last Update Date | 04/09/2011
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Provider Practice Location Address
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Address Line | 184 CALLE GUADALUPE
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City | PONCE
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State | PR
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Zip | 00730-3561
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Country | US
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Telephone | 787-709-4134
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 122
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City | COAMO
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State | PR
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Zip | 00769-0122
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Country | US
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Telephone | 787-595-0348
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Fax |
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Authorized Official
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Title or Position | CLINIC SOCIAL WORKER
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Name | MISS ALVARADO AIMEE MARTINEZ
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Credential | MSW
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Telephone | 787-595-0348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 10397
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License Number State | PR
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