Provider Demographics
NPI:1194020362
Name:CENTRO DE ESTIMULACION INTEGRAL
Entity Type:Organization
Organization Name:CENTRO DE ESTIMULACION INTEGRAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT BOARD
Authorized Official - Prefix:
Authorized Official - First Name:DORYLIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:VILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-405-2933
Mailing Address - Street 1:AVENIDA NOGAL T58
Mailing Address - Street 2:LOMAS VERDES
Mailing Address - City:BAYAMON
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00960
Mailing Address - Country:UM
Mailing Address - Phone:787-405-2933
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA NOGAL T58
Practice Address - Street 2:LOMAS VERDES
Practice Address - City:BAYAMON
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00960
Practice Address - Country:UM
Practice Address - Phone:787-405-2933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty