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General NPI Number Information
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NPI Number | 1912525999
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Entity Type | Organization
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Legal Business Name | CENTRO EMBRACE LIFE, CORP
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Dates
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Enumeration Date | 07/07/2020
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Last Update Date | 07/10/2020
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Provider Practice Location Address
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Address Line | CALLE ANDRES ARUS RIVERA #55 ALTOS
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City | GURABO
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State | PR
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Zip | 00778-0000
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Country | US
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Telephone | 787-359-7106
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Fax |
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Provider Business Mailing Address
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Address Line | #22 ESTANCIAS MONTESOL
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City | GURABO
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State | PR
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Zip | 00778-0000
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Country | US
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Telephone | 787-359-7106
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. GLORIAN RAMON SANTOS
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Credential | MA
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Telephone | 787-359-7106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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