Provider Demographics
NPI:1326256322
Name:SERVICIOS INTEGRALES PARA EL DESARROLLO HUMANO INC.
Entity Type:Organization
Organization Name:SERVICIOS INTEGRALES PARA EL DESARROLLO HUMANO INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IRELIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ-CINTRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1787-846-9488
Mailing Address - Street 1:PO BOX 2020
Mailing Address - Street 2:PMB 288
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-2020
Mailing Address - Country:US
Mailing Address - Phone:787-846-9488
Mailing Address - Fax:787-846-9488
Practice Address - Street 1:66 URB CATALANA
Practice Address - Street 2:
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-2725
Practice Address - Country:US
Practice Address - Phone:787-846-9488
Practice Address - Fax:787-846-9488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000698235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherPROVIDER #