Provider Demographics
NPI:1346969326
Name:CENTRO ETAAA CORPORATION
Entity Type:Organization
Organization Name:CENTRO ETAAA CORPORATION
Other - Org Name:CENTRO ETAAA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TRABAJO SOCIAL CLINICO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SENIA
Authorized Official - Middle Name:MARQUEZ
Authorized Official - Last Name:CANDELARIO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:787-614-2523
Mailing Address - Street 1:PORTAL DE LA REINA 78
Mailing Address - Street 2:CALLE REINA
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-2452
Mailing Address - Country:US
Mailing Address - Phone:787-614-2523
Mailing Address - Fax:
Practice Address - Street 1:PORTAL DE LA REINA 78
Practice Address - Street 2:CALLE REINA
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757-2452
Practice Address - Country:US
Practice Address - Phone:939-280-9326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRO ETAAA CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-24
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No251E00000XAgenciesHome Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Single Specialty