Provider Demographics
NPI:1417231176
Name:LUCY LOPEZ ROIG EAP, INC.
Entity Type:Organization
Organization Name:LUCY LOPEZ ROIG EAP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS DEVELOPMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:I
Authorized Official - Credentials:BBA
Authorized Official - Phone:787-763-6708
Mailing Address - Street 1:400 AVE DOMENECH
Mailing Address - Street 2:SUITE 701
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3710
Mailing Address - Country:US
Mailing Address - Phone:787-763-6708
Mailing Address - Fax:787-765-3650
Practice Address - Street 1:400 AVE DOMENECH
Practice Address - Street 2:SUITE 701
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3710
Practice Address - Country:US
Practice Address - Phone:787-763-6708
Practice Address - Fax:787-765-3650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)