Provider Demographics
NPI:1275989253
Name:OT COMMUNITY HEALTH SERVICES
Entity Type:Organization
Organization Name:OT COMMUNITY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTA
Authorized Official - Prefix:
Authorized Official - First Name:ZULEIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BULTRON AYALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-448-1778
Mailing Address - Street 1:1232 CALLE JULIAN BENGOCHEA
Mailing Address - Street 2:URBANIZACION SAN MARTIN
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924
Mailing Address - Country:US
Mailing Address - Phone:787-200-0567
Mailing Address - Fax:
Practice Address - Street 1:1232 CALLE JULIAN BENGOCHEA
Practice Address - Street 2:URBANIZACION SAN MARTIN
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924
Practice Address - Country:US
Practice Address - Phone:787-200-0567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty