Provider Demographics
NPI:1396409157
Name:MINDFUL ZOUL PSYCHOSOCIAL SERVICES
Entity Type:Organization
Organization Name:MINDFUL ZOUL PSYCHOSOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:KATHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:787-431-6948
Mailing Address - Street 1:12 CALLE PINEIRO STE 1
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-3498
Mailing Address - Country:US
Mailing Address - Phone:787-431-6948
Mailing Address - Fax:
Practice Address - Street 1:12 CALLE PINEIRO STE 1
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-3498
Practice Address - Country:US
Practice Address - Phone:787-431-6948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health