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General NPI Number Information
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NPI Number | 1841726312
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Entity Type | Organization
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Legal Business Name | ORGANIZACION DE AYUDA SICOLOGICA INTEGRAL Y SOCIAL
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Dates
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Enumeration Date | 05/03/2017
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Last Update Date | 05/03/2017
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Provider Practice Location Address
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Address Line | 506A CALLE JUAN J JIMENEZ AVENIDA DOMENECH
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City | SAN JUAN
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State | PR
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Zip | 00917-1904
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Country | US
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Telephone | 787-232-3011
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Fax |
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Provider Business Mailing Address
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Address Line | 30 CALLE AMATISTA URB VILLA BLANCA
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City | CAGUAS
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State | PR
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Zip | 00725-1904
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Country | US
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Telephone | 787-232-3011
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE
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Name | MR. MODESTO SANCHEZ
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Credential | LCDO
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Telephone | 787-232-3011
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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 | 5365
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License Number State | PR
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