Provider Demographics
NPI:1043497795
Name:INSTITUTO PSICOPEDAGOGICO DE PR
Entity Type:Organization
Organization Name:INSTITUTO PSICOPEDAGOGICO DE PR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MILAGROS
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:787-783-5431
Mailing Address - Street 1:PO BOX 363744
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-3744
Mailing Address - Country:US
Mailing Address - Phone:787-783-5431
Mailing Address - Fax:787-792-3610
Practice Address - Street 1:STREET #2 KILOMETER 8.5
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-783-5431
Practice Address - Fax:787-792-3610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities