Provider Demographics
NPI:1114189594
Name:APA HEALTHCARE CORP
Entity Type:Organization
Organization Name:APA HEALTHCARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARE MANAGER SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LESBIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:BETANCOURT
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:787-641-0774
Mailing Address - Street 1:NO 2 CHARDON AVENUE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HATO REY
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-641-0774
Mailing Address - Fax:787-641-0777
Practice Address - Street 1:NO 2 CHARDON AVENUE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-641-0774
Practice Address - Fax:787-641-0777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3906302F00000X, 302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3906Medicaid