Provider Demographics
NPI:1174009013
Name:SALUD INTEGRAL EN LA MONTANA, INC
Entity Type:Organization
Organization Name:SALUD INTEGRAL EN LA MONTANA, INC
Other - Org Name:CENTRO DE SALUD INTEGRAL EN BARRANQUITAS CAMP
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:DEL C
Authorized Official - Last Name:AMADOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-869-5900
Mailing Address - Street 1:PO BOX 515
Mailing Address - Street 2:
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719-0515
Mailing Address - Country:US
Mailing Address - Phone:787-869-5900
Mailing Address - Fax:787-869-6120
Practice Address - Street 1:CARR 156 CALLE BARCELO 53
Practice Address - Street 2:
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794
Practice Address - Country:US
Practice Address - Phone:787-857-2688
Practice Address - Fax:787-857-1730
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SALUD INTEGRAL EN LA MONTANA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-13
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center