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General NPI Number Information
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NPI Number | 1598750192
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Entity Type | Organization
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Legal Business Name | ADMINISTRACION DE SERVICIOS DE SALUD MENTAL Y CONTRA LA ADICCION
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 12/05/2018
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Provider Practice Location Address
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Address Line | COND MAGA BO MONACILLOS CENTRO MEDICO
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City | SAN JUAN
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State | PR
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Zip | 00907-1966
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Country | US
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Telephone | 787-766-4646
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Fax | 787-763-2344
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Provider Business Mailing Address
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Address Line | PO BOX 2100
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City | SAN JUAN
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State | PR
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Zip | 00922-2100
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Country | US
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Telephone | 787-766-4646
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Fax | 787-763-2344
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Authorized Official
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Title or Position | MANAGER
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Name | JIMMY BAEZ SALGADO
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Credential |
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Telephone | 787-763-7575
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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 | 9
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License Number State | PR
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