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General NPI Number Information
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NPI Number | 1558882209
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Entity Type | Organization
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Legal Business Name | CENTRO DE CONSEJERIA Y RECREACION KAIROS
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Dates
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Enumeration Date | 07/03/2017
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Last Update Date | 07/03/2017
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Provider Practice Location Address
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Address Line | CARR. 867, PARCELA 133, KM 7, HM. 07 BARRIO SABANA SECA
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City | TOA BAJA
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State | PR
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Zip | 00949
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Country | US
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Telephone | 787-230-7087
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Fax |
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Provider Business Mailing Address
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Address Line | ASUNCION BOBADILLA JS-7 SEPTIMA SECCION LEVITTOWN
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City | TOA BAJA
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State | PR
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Zip | 00949
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Country | US
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Telephone | 787-230-7087
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Fax |
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Authorized Official
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Title or Position | ADMINISTRADORA
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Name | MADELINE MOLINA VELAZQUEZ
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Credential | CPL
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Telephone | 787-364-9266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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