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General NPI Number Information
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NPI Number | 1780547034
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Entity Type | Organization
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Legal Business Name | CENTRO DE BIENESTAR INTEGRAL MINA LLC
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | CALLE JUAN R. GARZOT #33 LOCAL # 3
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City | NAGUABO
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State | PR
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Zip | 00718
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Country | US
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Telephone | 787-307-8285
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Fax |
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Provider Business Mailing Address
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Address Line | BO EL DUQUE BUZON 1961
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City | NAGUABO
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State | PR
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Zip | 00718
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Country | US
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Telephone | 787-307-8285
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MICHELLE I NAZARIO
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Credential | MPSY
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Telephone | 787-307-8285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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