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General NPI Number Information
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NPI Number | 1487040267
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Entity Type | Organization
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Legal Business Name | CDC GROUP SERVICES INC
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 04/08/2015
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Provider Practice Location Address
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Address Line | 36 CALLE ESTRELLA
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City | PONCE
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State | PR
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Zip | 00730-3832
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Country | US
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Telephone | 787-598-4528
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 893
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City | JUANA DIAZ
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State | PR
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Zip | 00795-0893
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Country | US
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Telephone | 787-598-4528
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Fax | 787-837-8668
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. DELGIA CRUZ
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Credential | CPL
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Telephone | 787-598-4528
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4010
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License Number State | PR
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