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General NPI Number Information
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NPI Number | 1659926806
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Entity Type | Organization
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Legal Business Name | CENTRO DE SERVICIOS CONTRA ADICCIONES ENLACE.INC
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Dates
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Enumeration Date | 08/05/2019
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Last Update Date | 08/05/2019
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Provider Practice Location Address
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Address Line | 20 CALLE RAMON EMETERIO BETANCES ALTOS CASCO URBANO
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City | VEGA BAJA
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State | PR
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Zip | 00693
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Country | US
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Telephone | 787-943-5055
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 210
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City | CATANO
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State | PR
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Zip | 00963-0210
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Country | US
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Telephone | 787-231-8726
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Fax |
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Authorized Official
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Title or Position | VICEPRESIDENT
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Name | DR. AILEEN IVONNE CABAN
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Credential | EDD
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Telephone | 787-231-8726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number |
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License Number State |
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