Provider Demographics
NPI:1407106586
Name:CENTRO C.I.E.H.L.O.INC.
Entity Type:Organization
Organization Name:CENTRO C.I.E.H.L.O.INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:IVELISSE
Authorized Official - Middle Name:
Authorized Official - Last Name:PINERO
Authorized Official - Suffix:
Authorized Official - Credentials:MS,SLP
Authorized Official - Phone:787-692-2422
Mailing Address - Street 1:A49 CALLE MARGINAL
Mailing Address - Street 2:URB. BARALT
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-3759
Mailing Address - Country:US
Mailing Address - Phone:787-801-2966
Mailing Address - Fax:
Practice Address - Street 1:A-49 CALLE MARGINAL
Practice Address - Street 2:URB. BARALT
Practice Address - City:FAJARDO
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00738
Practice Address - Country:AL
Practice Address - Phone:787-801-2966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-15
Last Update Date:2012-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR908261QH0700X
PR3991261QM0855X
PR1097261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR908OtherSPEECH AND LANGUAGE PATHOLOGY