=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720800725
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | YO CUIDO MI SALUD MENTAL LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/30/2024
-----------------------------------------------------
Last Update Date | 10/30/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CARR 110 KM 24.2 PLAZA CABAN LOCAL 3
-----------------------------------------------------
City | AGUADILLA
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00603
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-415-2424
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 5106
-----------------------------------------------------
City | AGUADILLA
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00605-5106
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-415-2424
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENTE
-----------------------------------------------------
Name | MRS. PAOLA N CINTRON
-----------------------------------------------------
Credential | MS
-----------------------------------------------------
Telephone | 787-415-2424
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------