Provider Demographics
NPI:1225430671
Name:CENTRO DE SERVICIOS PSICOTERAPEUTICOS INTEGRADOS
Entity Type:Organization
Organization Name:CENTRO DE SERVICIOS PSICOTERAPEUTICOS INTEGRADOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NILFRA
Authorized Official - Middle Name:EDMEE
Authorized Official - Last Name:SEISE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:787-378-6513
Mailing Address - Street 1:PO BOX 827
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-0827
Mailing Address - Country:US
Mailing Address - Phone:787-378-6513
Mailing Address - Fax:
Practice Address - Street 1:CARR. #2 KM. 56.0
Practice Address - Street 2:PLAZA BARCELONETA #8
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617
Practice Address - Country:US
Practice Address - Phone:787-378-6513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4047103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty