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General NPI Number Information
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NPI Number | 1508183005
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Entity Type | Organization
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Legal Business Name | YAUCO HEALTHCARE CORP
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 04/23/2010
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Provider Practice Location Address
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Address Line | CARR. 128 KM. 1.0
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City | YAUCO
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State | PR
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Zip | 00698
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Country | US
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Telephone | 787-856-1000
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Fax | 787-856-4250
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Provider Business Mailing Address
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Address Line | PO BOX 5643
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City | YAUCO
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State | PR
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Zip | 00698-5643
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Country | US
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Telephone | 787-856-1000
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Fax | 787-856-4250
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Authorized Official
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Title or Position | CEO
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Name | PEDRO F BAREZ
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Credential | MHSA FACHE
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Telephone | 787-856-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | CASC-0462
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License Number State | PR
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